Joan writes:

>
>
>2) Fact - relative risk does NOT give cause and effect results. It's a
>ratio of the rates of X in exposed and unexposed populations. So when we
>say that the relative risk of SIDS in babies who are formula fed vs.
>babies who are breastfed is 2, we're saying that 2 times as many babies
>fed formula die of SIDS than babies who are breastfed. We're not saying
>formula feeding causes SIDS. It's the same with any other parameters we
>use. Yes, we have enough information to thoroughly document that formula
>increases the risk of many, many diseases but, with the exception of
>formula improperly reconstituted or mixed with contaminated water, we
>can't say formula causes these. And in the case of reconstitution or
>contaminated water, it's not the formula itself, anyway.



But I think I'm right in saying that not *all* the bf research looks only at
relative risk in this sort of purely epidemiological way. Some of it
truly does pinpoint causes....not the SIDS research, I grant you,
where cause and effect is more speculative, and is more about (an
example among a number) the possibility of formula feeding depressing
the immune system.

However, we have a good knowledge of the way formula actually works
in the gut to affect the body's ability to deal with pathogens and
foreign protein. I think we can say confidently that formula *causes*
a range of conditions.


>
>When a mom who does not want to breastfeed starts hearing why it's
>important and asks "If I just give my baby colostrum will that help?"
>"YES!" I say, "How wonderful that you would do that for your baby!" Then
>as she hears more in the group she says "Well, what if I just breastfeed
>my baby for two weeks and then stop?" "Absolutely - that would be
>great!" And finally when another mom says "I think you're really
>starting to think you might breastfeed" and she replies "Yeah, but I'm
>afraid I'll like it and won't be able to stop" I say "That's the idea!"
>(This truly happened in a group). But I think if my initial reaction was
>that colostrum wasn't enough, I would have lost her and that would be
>one less baby breastfed.

I am still working on this one! Like you, Joan, I recognise the
importance of support and encouragement, and being appreciative of
whatever the mother feels she can do at this time - knowing (as we
all do!) mothers who thought they'd 'give it a try for a couple of
days' and who then go on months and years, precisely because they
like it!  But I am now wondering if we should give the truth - that
giving colostrum and nothing else is nice, and probably better than
nothing, but it is not wonderful or great!  OTOH, maybe it is
wonderful or great for that particular mother - but truly, a day or
so of colostrum is a gazillion miles away from the norm.  How do we
phrase that, to increase a mother's confidence, and not undermine it,
and to tell her the truth?

I mean, if one feed of colostrum is wonderful, you're gonna run out
of adjectives if she asks you about feeding for a few years :))))

Like I say, I'm working on it!

Heather Welford Neil
NCT bfc Newcastle upon Tyne UK

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