On 14/05/2012 06:01, Maria Paciullo wrote:
>>
>>> yes, it is 205 Canadian….and there are more than 20 excellent presentations, including Roy Philip re breastmilk and premature babies.  We all know the science is there re morbidity rates for babies fed with artificial substitutes v. human milk.

Absolutely, and I am in no way disputing that the research shows clear 
and significant differences between *breastfeeding* and formula 
feeding.  However, for the reasons I've already given, it isn't valid to 
make assumptions that all these differences will persist when the human 
milk in question is donated pasteurised milk fed from a bottle.  There 
are simply so many differences between that and breastfeeding.

>>>     In any case, here is a link to just one article
> http://www.internationalbreastfeedingjournal.com/content/6/1/8
>
Thank you - I greatly appreciate you taking the trouble to look this out 
for me.  However, it didn't actually address any of the concerns I'd 
raised re. differences between donor milk/breastmilk or cost-effectiveness.

I would also add that Akre's take on the subject is rather different 
from the viewpoint I was countering here.  Akre is arguing for informal 
milk sharing networks to remain available for parents who choose to use 
them, in the context of 'acknowledging that, here as elsewhere, parents 
are responsible for making informed choices about what is best for their 
children'.  The view that I was disputing, as expressed by a poster on 
here, is that milk donation should entirely *replace* formula.  That's a 
very different matter indeed, and, in addition to the concerns I've 
already spent some time detailing, is effectively the antithesis of the 
attitude that parents are responsible for making informed choices about 
what is best for their children.  If this situation ever were to be 
brought about - i.e. that donor milk was made the only alternative to 
breastfeeding, and formula was no longer produced - that would, in 
effect, force that choice on those parents who would have wished to 
chose formula over donor milk.

I would find that extremely objectionable.  Currently, if I were to have 
a baby whom I could not fully supply with my own milk, thus leaving me 
with a choice between human milk from an informal milk sharing network 
and formula milk, I would choose formula.  That is not, as some might 
wish to assume, due to ignorance: it is a decision into which I have put 
careful thought and research (and one which I am happy to explain if 
anyone is curious).  I accept and respect that many women, faced with 
that choice, will make a different decision.  In turn, I ask them to 
accept and respect mine.  I would *not* be happy with a situation where 
my chosen option was removed by external diktat.  So, that is another 
reason why I don't agree with the blithe expectation that we should be 
able to work towards simply eradicating formula and expecting every 
non-breastfeeder or mixed feeder to use donor milk instead.

Thanks for an interesting and lively discussion, and I respect your 
decision to agree to differ.


Best wishes,

Dr Sarah Vaughan
MBChB MRCGP

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