Chris asked whether there is EVIDENCE to support exclusive breastfeeding in
the early weeks before adding formula.  I think there is plenty of evidence
to support exclusive breastfeeding in the early days.  There are plenty of
patents on the use of human milk components--particularly human
lactoferrin--to protect the gut.  These patents are based on the research
done on human milk.  Without that early milk, babies are subjected to health
problems and not just health problems as an infant but health problems into
adulthood.  Human milk not only protects the gut but helps gut growth.  We
have a huge study done by the CDC (Scariati et al.) on the dose-related
response of breastmilk.  There are other studies supportive of the
dose-related response of breastmilk. (Raisler et al.) The more breastmilk a
baby gets, the better the protection against disease.  We have the Coutsoudis
study that shows the protective role of exclusive breastfeeding against hiv
transmission.  I would suggest we have so much evidence that one might view
it as a national tragedy the number of infants that do not receive this
life-enhancing substance exclusively in the early weeks.

Infant formula is a poor imitation of human milk and we now have recombinant
forms of human milk components in formula.  Shouldn't women be well-advised
that this new technology has unknown ramifications?  These ramifications
maybe far worse than the old-style formulas--although it might be better.  We
don't know. Do women really want to set their infants up as guinea pigs to
the infant formula industry?

I have always been curious about what we call "overproduction."  What is
evidence of overproduction?  Is evidence based on a mother's description of
her problem?  Is overproduction often a case of erratic nursing patterns
rather than having too much milk?  By this I mean that the mother goes far
too long between feeds and thus has full breasts.  When we receive
descriptions from mothers about oversupply, are we asking questions about her
nursing patterns?  Erratic nursing patterns increase the liklihood of
overfull breasts, engorgement.  This in turn decreases milk supply because
very full breasts or engorgment is really about a milk supply going through
the shutting down process.  Mothers assume the opposite that over-full
breasts mean a great milk supply and not full breasts mean poor milk supply.

As someone who has relactated and helped other mothers relactate, I think it
is a mistake to believe that there is a point of no return when the breast
involutes.  There might be a rare case of this situation but overall
recovering a milk supply is not as physically difficult for the mother as it
is mentally difficult.

I actually don't think exclusive breastfeeding is as complicated as mixed
feeding.  Adding formula feeding makes a very simple system truly complex and
will impact an infant's health.    There is indeed alot to think about and
puzzle over.  Valerie W. McClain, IBCLC

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