Denise mentioned something I didn't know: that a so called supplementation
formula is being launched now.
'Pediatrics' is the official journal of the same organization that sold a
breastfeeding book to a formula company not once but TWICE, so it could be
branded by the formula company and presented to new mothers as if the
formula manufacturer had something to do with the content.
I strongly suspect that the AAP's sponsors, in this case the collective
formula industry, were not encouraged to use their press contact machinery
to make sure this article was seen. Formula industry gains a boost to its
overt marketing, AAP thinks it benefits from having attention-grabbing
research published in its own journal.
The trouble with this kind of tie between a commercial entity and a
professional body is that it leaves room for doubt as to whose interests
the professional organization represents, and the organization's members
are tainted by association. Only strong action from members is likely to
bring an improvement in the organization's ethics, as long as the law
leaves enpugh leeway for bad judgment to prevail.
The first author of this study is a pediatrician who is very committed to
breastfeeding. She is the author of the study that found dramatic
differences in bf continuation among mothers of banies who fed poorly in
the first days, dependent on whether they were advised to pump or express
colostrum manually. Manual expression the first days was associated with
much higher continuation rates later.
The article doesn't say what mothers in the control group were taught about
soothing. For all we know they were advised to offer the breast first, it
simply doesn't say.
About making sure the control group babies weren't given formula, this
would not have been possible or even desirable from the standpoint of the
study, which aimed to find out whether standard care plus a few minutes of
instruction about soothing techniques differed from early supplementation
of small amounts of formula, in babies who had lost over 5% of birth weight
at 36 hours. As standard care includes the possibility of a mother
requesting and getting formula for dubious reasons, we can expect that it
occurred.
The study is extremely small. For that reason,, it could have been rejected
for publication, but somehow it made the grade. I think it might be equally
pertinent to find out about that, as to criticize the study itself.
Rachel Myr, Kristiansand, Norway

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