Too bad she had to add that 2nd to last paragraph!
Kathleen Fallon Pasakarnis, IBCLC

Breast-Feeding Benefits Touted In New Study
   
March 27, 2002
By Stephanie Whyche
InteliHealth News Service

Despite mounting evidence for the benefits of breast milk, American women 
face many challenges when it comes to breast-feeding — take it from an expert 
at Harvard Medical School, who is also a mother.

Leann M. Lesperance, M.D., a clinical instructor in pediatrics and a staff 
affiliate at Boston Children's Hospital and Brigham and Women's Hospital, 
says the challenges range from a lack of basic instruction on breast-feeding 
to workplace policies, as well as social and cultural biases.

Still, she's convinced, "breast is best."

Her comments come in the wake of a new study that showed that full-term 
babies who were small at birth and who were exclusively fed breast milk for 
the first six months of their lives scored an average of 11 points higher on 
IQ tests at age 5, compared with similar-sized babies who were fed breast 
milk and formula, or breast milk and solid food.

The study took place in Norway and Sweden and was conducted by researchers at 
the U.S. National Institute of Child Health and Human Development and the 
Norwegian University of Science and Technology.

This study is not the first to tout the benefits of breast-feeding for 
intellectual development. An earlier study showed that full-term, breast-fed 
babies of average size who were exclusively breast-fed scored three points 
higher on IQ tests at age 5 than those who were not. 

"One of the benefits of breast-feeding that has long been promoted is that it 
may have cognitive benefits for kids," says Dr. Lesperance, who breast-fed 
her own child for 13 months. "We have to assume that breast milk contains the 
perfect ingredients that our children need to develop to their fullest 
potential."

"People have been studying this for many years," she says. "Much research has 
focused on long-chain polyunsaturated fatty acids [found in human breast 
milk]. They are similar to compounds found in fish oils." Experts are 
particularly interested in DHA, docosahexaenoic acid. "Some studies suggest a 
link between cognitive ability and DHA. Indeed, the U.S. Food and Drug 
Administration has recently approved DHA as an additive for baby formula," 
Dr. Lesperance says.

"The rewards are great, but the initial investment in time and energy can be 
high," Dr. Lesperance says of breast-feeding. "You've got to be motivated; it 
takes commitment." 

But Dr. Lesperance tells mothers of infants she cares for in her own practice 
to stay the course if possible. In most cases, breast-fed babies and their 
moms will be better off for the experience, she says. 

The latest study, reported in the March edition of the journal Acta 
Paediatric, took place in two countries — Norway and Sweden — where most 
mothers exclusively breast-feed their babies for the first six months. (In 
the United States, only 16 percent of mothers are still nursing their babies 
at six months.) The researchers compared 220 full-term babies who were small 
with 229 full-term babies of average size. The infants were examined at 
birth, 6 weeks of age, 3 months, 6 months, 9 months and 13 months. At each 
visit, the babies were weighed and mothers were asked what they were feeding 
their children.

Development was measured at each of those visits, and intelligence tests were 
given at age 5. 

In addition to the difference in IQ tests, researchers noted that the early 
introduction of formula or food did not increase the growth of either the 
small or average weight babies compared to those who were exclusively breast 
fed for six months.

The American Academy of Pediatrics recommends exclusive breast-feeding of 
infants until 6 months of age, then breast-feeding to the age of 1 year, if 
possible, supplemented by solid food. Most babies do not need any type of 
solid foods before 6 months of age, Dr. Lesperance says.

So why do so few American moms breast feed for more than a few months, if at 
all, compared to women in other countries? One reason is work. When it comes 
to meeting the competing demands of work or breast-feeding, work wins out for 
many women. 

One big factor, Dr. Lesperance says, is that workplace maternity-leave 
policies in the two Scandinavian countries are more conducive to prolonged 
breast-feeding than policies in the United States. To wit: 

In Norway, a woman can get up to 42 weeks of fully paid maternity leave (and 
52 weeks at 80 percent pay) if she has worked six months out of the previous 
10 months. 

In Sweden, a woman can get 15 months of maternity leave with pay and job 
protection. In that country 70 percent of moms are exclusively breast-feeding 
at 4 months. 

The United States Family and Medical Leave Act only guarantees 12 weeks of 
maternity leave with job protection, not pay, for women who work for 
companies with 50 or more employees. Whether they are paid is up to 
individual employers. Other factors likely play a role in the lower 
percentages of breast-feeding mothers in the United States, according to Dr. 
Lesperance. These include:

Few or no role models — Many women have no prior experience with 
breast-feeding. They have no role models, since their mothers, aunts or 
friends did not breast-feed. "If breast-feeding is not prevalent in your 
community you will have very few social supports," Dr. Lesperance says. 

Poor prenatal training — "I think if a mom doesn't receive appropriate 
prenatal counseling then she often has unrealistic expectations about 
breast-feeding and may not even try or may quit because she encounters 
difficulties and is unprepared," she says. 

Lack of encouragement — Mothers are not necessarily encouraged to breast-feed 
by the hospital where the baby is delivered or by their pediatricians. 

Poor postpartum training — Very few hospitals in this country are considered 
breast-feeding friendly, she says. Most moms are discharged after only 48 
hours, limiting the time that can be devoted to breast-feeding education. 

Misunderstanding about when breast-feeding should be avoided — "Some of the 
things that people think are contraindications to breast-feeding are not," 
Dr. Lesperance says. Moms who have nipple problems (such as flat or inverted 
nipples) still can nurse their babies, she says. True contraindications are 
actually rare. For instance, it is not recommended that a mother who has 
tested positive for HIV breast-feed her baby since the virus can be 
transmitted through the milk to the child and infant formula is a safer 
alternative. 

Pro baby-formula images in media — One study showed that most advertisements, 
television shows and movies don't show mothers breast-feeding but, instead, 
show mothers feeding bottled formula to their babies. "No one should feel bad 
about switching to a bottle," Dr. Lesperance says. 

"Formula is an excellent alternative for moms who cannot or chose not to 
breast-feed." What's important is that moms who decide to give formula " do 
so for the right reasons, she says, "not because of myths or misinformation."

"My advice to expectant moms is to think about breast-feeding before the baby 
is born," Dr. Lesperance says. "Be prepared. Get enough information: attend a 
class, read books. Explore your own viewpoints and biases. When the baby is 
born, don't be discouraged if it seems difficult, because it can be 
challenging. In the long run, however, it usually gets even easier than 
bottle feeding and may have lasting rewards for your baby."



   

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