Sunday
Nov282010
Risks of Informal Breastmilk Sharing versus Formula Feeding
Sunday, November 28, 2010
Anyone who has even thought about having a child recently has certainly had the "Breast is Best" message hammered into their brain. They have probably also heard countless tales of women who found breastfeeding difficult or impossible and have probably heard them say that infant formula is an acceptable alternative. While there is nothing wrong with those statements, there is a whole lot missing from the middle. What gets lost in the breast vs. formula debate is the option to use donor milk.
According to the World Health Organization's Global Strategy for Infant and Young Child Feeding (p.10):
The problem, for any baby that is not able to be exclusively breastfed by its own mother, is that there are risks to any alternate feeding method. In the absence of easily accessible and affordable breast milk from human milk banks, the determination of the best choice for those "individual circumstances" requires an assessment of the risks of various feeding methods that will never provide a clear and perfect answer.
The Canadian Pediatric Association has called for the creation of more human milk banks in Canada and the Montreal Gazette has reported that Hema-Quebec (the blood collection agency) is looking into the possibility of establishing a human milk bank in Quebec. The United States has more human milk banks than Canada, but even there obtaining breast milk from a human milk bank can be difficult and expensive.
Until our governments and health care organizations make human milk banks a priority (like they do with blood), families whose babies need breastmilk (because they cannot tolerate formula) or whose babies would benefit from breastmilk (over formula) are left with no choice but to seek out informal milk sharing arrangements. In response to the growing demand for human milk, a number of informal milk sharing arrangements (e.g. Milkshare, HM4HB - Human Milk for Human Babies) have been established. They have gained a significant amount of profile recently through articles in the Montreal Gazette and Time magazine, among others. Health Canada has raised concerns about these arrangements and the Canadian Pediatric Association has said that it does not support the sharing of unprocessed milk.
However, at the same time, the government is making little progress in ensuring that women are able to feed their babies breastmilk. The government:
In short, the formula companies are not prevented from using unethical marketing practices, we need human milk banks but don't have them, and the government is ready to criticize parents rather than fixing the problem. So, as people lobby the government to fix this problem, mothers who are not able to exclusively breastfeed their babies are left with a difficult choice: informal milk sharing or infant formula. What are the benefits and risks of both?
The benefits of infant formula are:
The risks of infant formula include:
Some of the risks of using formula can occur even with just one bottle (e.g. gut closure which makes the baby more susceptible to bacteria and disease) and others occur only when a baby is exclusively formula fed. Or, put another way, every bit of breastmilk helps, but exclusive breastfeeding is required to gain the full range of benefits that come with breastfeeding. From that perspective, when a mom is unable to produce enough milk to exclusively breastfeed, it is understandable that the World Health Organization recommends using donor milk before considering formula.
For some babies, the risks of formula are more acute than others. Some infants are able to grow and develop on infant formula. However, some babies with failure to thrive, formula intolerance, allergies and other medical conditions may not be able to use formula at all. The fact that there is only one human milk bank in Canada is an even bigger injustice for those babies than for for the average baby that cannot access donor breastmilk.
The benefits of informal milk sharing are:
The risks of informal milk sharing include:
A lot of these risks can be significantly mitigated by screening the donor through interviews and blood tests. Human Milk 4 Human Babies has a series of suggestions on things you may wish to discuss with a potential donor in their FAQs (e.g. Recipients can ask donors to take blood tests or other health screenings).
The recipient parents will have to decide what they are willing to accept and not willing to accept from a donor. Some may be willing to accept a donor who smokes, has a glass of wine with dinner, and takes an Advil every once in a while. Others may decide that they are not willing to accept that. Some parents may decide they are only willing to accept donors they know personally because being able to trust the other person is important to them, whereas others may be willing to accept milk from a stranger if they have undergone certain screenings.
It is important to remember that both informal milk sharing and infant formula have risks. In both cases, some of the risks can be mitigated, but they cannot be entirely eliminated. The difference between the two is that:
Which risks are you more willing to accept -- those that come with infant formula or those that come with donor breastmilk? How much work are you willing to do in order to provide your baby with breastmilk? Those are questions that only you can answer. For some, those answers will come easily and for others the decision making process will be agonizingly difficult.
It shouldn't have to be this hard though. Something needs to be done about the availability of pasteurized donor milk in Canada, especially for at-risk babies and for short-term needs (e.g. a mom who is suffering from a short-term supply issue).
Image credit: Daquella manera on flickr
According to the World Health Organization's Global Strategy for Infant and Young Child Feeding (p.10):
For those few health situations where infants cannot, or should not, be breastfed, the choice of the best alternative – expressed breast milk from an infant’s own mother, breast milk from a healthy wet-nurse or a human-milk bank, or a breast-milk substitute fed with a cup, which is a safer method than a feeding bottle and teat – depends on individual circumstances. ...
...Infants who are not breastfed, for whatever reason, should receive special attention from the health and social welfare system since they constitute a risk group.
The problem, for any baby that is not able to be exclusively breastfed by its own mother, is that there are risks to any alternate feeding method. In the absence of easily accessible and affordable breast milk from human milk banks, the determination of the best choice for those "individual circumstances" requires an assessment of the risks of various feeding methods that will never provide a clear and perfect answer.
Lacking access to pasteurized human milk
The Canadian Pediatric Association has called for the creation of more human milk banks in Canada and the Montreal Gazette has reported that Hema-Quebec (the blood collection agency) is looking into the possibility of establishing a human milk bank in Quebec. The United States has more human milk banks than Canada, but even there obtaining breast milk from a human milk bank can be difficult and expensive.Until our governments and health care organizations make human milk banks a priority (like they do with blood), families whose babies need breastmilk (because they cannot tolerate formula) or whose babies would benefit from breastmilk (over formula) are left with no choice but to seek out informal milk sharing arrangements. In response to the growing demand for human milk, a number of informal milk sharing arrangements (e.g. Milkshare, HM4HB - Human Milk for Human Babies) have been established. They have gained a significant amount of profile recently through articles in the Montreal Gazette and Time magazine, among others. Health Canada has raised concerns about these arrangements and the Canadian Pediatric Association has said that it does not support the sharing of unprocessed milk.
However, at the same time, the government is making little progress in ensuring that women are able to feed their babies breastmilk. The government:
- Does not appear to be making any moves towards establishing a strategy for human milk banks in Canada.
- Has signed but does not enforce the WHO Code of the Marketing of Breast-Milk Substitutes.
- Has admitted that it its attempts to stop infant formula manufacturers from using unproven or misleading claims have been ineffective.
In short, the formula companies are not prevented from using unethical marketing practices, we need human milk banks but don't have them, and the government is ready to criticize parents rather than fixing the problem. So, as people lobby the government to fix this problem, mothers who are not able to exclusively breastfeed their babies are left with a difficult choice: informal milk sharing or infant formula. What are the benefits and risks of both?
Infant Formula
The benefits of infant formula are:
- It is a regulated manufactured substance that must comply with certain standards.
- It is easily accessible in a wide variety of convenient retail locations (albeit at a cost that may not be affordable to many).
The risks of infant formula include:
- Babies are more susceptible to bacteria and disease (see "Just One Bottle Won't Hurt" -- Or Will It?).
- Higher risk of wide variety of health problems (see Scientific Benefits of Breastfeedingfor more details), such as:
- Middle ear infections
- Eczema
- Gastrointestinal infections
- Lower respiratory tract diseases
- Asthma
- Type 1 diabetes
- Type 2 diabetes
- Childhood leukemia
- Sudden infant death syndrome
- Possible contamination of infant formula during the manufacturing process (despite regulations that are in place), e.g.
- Substances sneaking into formula that should not be there, such as melamine or beetles.
- E.zakazakii infections, which can result in neonatal meningitis and has caused the death of infants, is considered to be significantly under-reported in all countries. E.zakazakii outbreaks linked to infant formula has been reported as causing deaths in infants in developed countries as recently as 2004 in France (see WHO's Guidelines in the Safe Preparation, Storage and Handling of Powdered Infant Formula - p.3).
- Salmonella outbreaks associated with infant formula have been recorded in Canada, France, Korea, Spain, the UK and the United States since 1995 (see WHO's Guidelines in the Safe Preparation, Storage and Handling of Powdered Infant Formula - p.3).
- Tampering with infant formula, such as the recent tampering with Nestle Good Start formula cans in Canada.
- Use of toxic chemicals such as BPA in the packaging for infant formula.
- In susceptible families, breastfed babies who are supplemented with formula can be sensitized to cow's milk protein, resulting in allergic reactions (see "Just One Bottle Won't Hurt" -- Or Will It?).
- Risks in the water that is used to prepare infant formula, including:
- Possible bacteria in the water (this risk can be minimized by boiling water).
- Flouride in municipal water systems, which can cause dental flourosis, may damage the developing brain, can act as an "endocrine disrupter" thereby disrupting thyroid function, and may be linked to bone cancer (see Flouride Warning for Infants).
- Contamination or bacteria growth due to improper preparation, storage and handling of infant formula (including not washing hands, not sterilizing bottles, etc).
Some of the risks of using formula can occur even with just one bottle (e.g. gut closure which makes the baby more susceptible to bacteria and disease) and others occur only when a baby is exclusively formula fed. Or, put another way, every bit of breastmilk helps, but exclusive breastfeeding is required to gain the full range of benefits that come with breastfeeding. From that perspective, when a mom is unable to produce enough milk to exclusively breastfeed, it is understandable that the World Health Organization recommends using donor milk before considering formula.
For some babies, the risks of formula are more acute than others. Some infants are able to grow and develop on infant formula. However, some babies with failure to thrive, formula intolerance, allergies and other medical conditions may not be able to use formula at all. The fact that there is only one human milk bank in Canada is an even bigger injustice for those babies than for for the average baby that cannot access donor breastmilk.
Informal Milk Sharing
The benefits of informal milk sharing are:
- Babies have access to human milk, which is designed by nature to meet their nutritional needs.
- Babies, especially those at risk, do not have to be exposed to the many risks of infant formula. This is especially beneficial in instances where the donor milk would be used on a temporary basis (e.g. as the mom builds her supply), thereby allowing her to avoid the risks that come from the introduction of a small amount of formula.
- Families save money by not having to purchase extremely expensive and difficult to obtain pasteurized milk or infant formula.
The risks of informal milk sharing include:
- Possible transmission of HIV via breastmilk. However:
- According to the CDC:
- The risk of HIV transmission from expressed breast milk consumed by another child is believed to be low because:
- In the United States, women who are HIV positive and aware of that fact are advised NOT to breastfeed their infants
- Chemicals present in breast milk act, together with time and cold temperatures, to destroy the HIV present in expressed breast milk
- Transmission of HIV from single breast milk exposure has never been documented
- The risk of HIV transmission from expressed breast milk consumed by another child is believed to be low because:
- According to research from the University of California:
- Babies that do not receive any formula have a much lower chance of contracting HIV from contaminated breastmilk than those who have received some formula.
- Flash heating can be used to kill the HIV in breastmilk.
- According to the CDC:
- Possible transmission of other sexually transmitted diseases:
- Prescription or over-the-counter drugs, alcohol or tobacco use by the donor:
- Most drugs are minimally excreted into breastmilk and many drugs are perfectly safe to take while breastfeeding.
- According to the Newman Breastfeeding Clinic and Institute "there are plenty of risks in not breastfeeding, so the question essentially boils down to: Does the addition of a small amount of medication to the mother’s milk make breastfeeding more hazardous than formula feeding? The answer is almost never. Breastfeeding with a little drug in the milk is almost always safer. In other words, being careful means continuing breastfeeding, not stopping." This is echoed by Health Canada. There are certainly some drugs that are unsafe, but generally women who are taking those drugs would not be breastfeeding and therefore not be in a place to be donating milk.
- Alcohol does pass into the breastmilk, but only in very small amounts. A woman would have to be very drunk while breastfeeding/pumping in order for it to create a risk to the infant. Small amounts of alcohol while breastfeeding is fine.
- Mothers who smoke are encouraged to quit during pregnancy and breastfeeding. However, smoking and breastfeeding is still better than smoking and formula feeding.
- Most drugs are minimally excreted into breastmilk and many drugs are perfectly safe to take while breastfeeding.
- Possible contamination of milk through improper storage or handling (similar to with formula, albeit with some different guidelines to follow).
A lot of these risks can be significantly mitigated by screening the donor through interviews and blood tests. Human Milk 4 Human Babies has a series of suggestions on things you may wish to discuss with a potential donor in their FAQs (e.g. Recipients can ask donors to take blood tests or other health screenings).
The recipient parents will have to decide what they are willing to accept and not willing to accept from a donor. Some may be willing to accept a donor who smokes, has a glass of wine with dinner, and takes an Advil every once in a while. Others may decide that they are not willing to accept that. Some parents may decide they are only willing to accept donors they know personally because being able to trust the other person is important to them, whereas others may be willing to accept milk from a stranger if they have undergone certain screenings.
Which is riskier? Informal human milk sharing or formula?
It is important to remember that both informal milk sharing and infant formula have risks. In both cases, some of the risks can be mitigated, but they cannot be entirely eliminated. The difference between the two is that:
- Many of the risks of human milk can be significantly decreased or eliminated through diligence on behalf of the donor and recipient.
- Many of the risks of infant formula are ever-present -- i.e. no amount of care or diligence by the formula companies or the parents will erase the health problems that can result from feeding formula.
Which risks are you more willing to accept -- those that come with infant formula or those that come with donor breastmilk? How much work are you willing to do in order to provide your baby with breastmilk? Those are questions that only you can answer. For some, those answers will come easily and for others the decision making process will be agonizingly difficult.
It shouldn't have to be this hard though. Something needs to be done about the availability of pasteurized donor milk in Canada, especially for at-risk babies and for short-term needs (e.g. a mom who is suffering from a short-term supply issue).
Image credit: Daquella manera on flickr
Reader Comments (112)
Adrienne:
I agree that mothers who are nursing should be encouraged to limit alcohol and not engage in heavy drinking. However, I do stand by my statement that a mom has to be very drunk in order for her milk to harm her baby. The evidence is there in the post that I linked to (and copied in one of the comments here questioning that already). A mother who is too drunk to breastfeed is too drunk to be caring for a child. Parents should not be drunk while caring for their children, period. So it isn't really a breastfeeding issue, it is a parenting issue, unless we are talking about a mom who has left her child with a sober caregiver and is pumping while out drunk at a party.
I have certainly worked with women who felt the need to "party" and leave the baby with another adult--they wanted to know when they could breastfeed, if they had to pump and dump, etc.
The link is to an article of yours with links to LLL and other sources. The Hale book has been updated and is now the 14th edition. He has cited more research. While heavy users do seem to produce the most severe health consequences in the babies (and some are extreme: Cushing-like syndrome and seizures), "...studies suggest that changes in behavioral state such as shorter periods of sleep, [crying] more often, and... heightened startling reflexes after exposure to alcohol." (Hale, p. 382).
According to Hale, alcohol can significantly alter milk production or release temporarily. In one study, milk consumption in the 4 hours following alcohol consumption was significantly less than normal for the infants studied. After the alcohol wore off, the infants exhibited an increased feeding behavior, likely to "catch up" on their intake.
Hale recommends no breastfeeding for at least 2-3 hours after consuming "moderate" amounts of alcohol.
Annie-
Didn't mean to imply that your POST was using JN's philosophy - I was just referring to the passage where you quoted him on the risks of donor milk vs the risks of formula. I thought the rest of your post was great! I would love to see more research and normalization of donor milk...I think it would be a wonderful option for many women and children.
But isn't that a bit troubling, that for the sake of possible nipple confusion they are using a highly intrusive manner of feeding? That seems kind of extreme. An SNS makes much more sense to me... or if the situation is that dire, and the baby simply can't latch, then the help of a good LC can usually remedy the situation down the line.
Adrienne:
Yes, I've seen the info about alcohol intake potentially impacted milk supply. However, that wouldn't be an issue for the recipient of milk from a donor, unless they were worried the mom wouldn't maintain her supply over time. My intention was simply to note that the concern about potential alcohol in donor milk is overstated.
Here's an interesting study about the antioxidants in breastmilk... it showed that in the case of antioxidants, formula actually fared significantly better than frozen, stored breastmilk. I think Dr. Sarah brings up an excellent point.
http://www.news-medical.net/news/2004/10/21/5707.aspx
Fearless Formula Feeder:
From what I understand, in a NICU environment, the use of a feeding tube is fairly common -- not just for babies who cannot latch to the breast, but for babies who cannot suck on a bottle. I think it is a good alternative to a bottle for a baby that the parents are hoping to be able to breastfeed eventually. Not all nipple confusion can simply be overcome by working with a good LC.
Fearless Formula Feeder:
Unfortunately, the "full paper" link from that page doesn't work anymore. I do know that fresh breastmilk is the best, followed by refrigerated and then frozen. When I was working and pumping, my plan was generally to:
- Nurse on one side and pump on the other after waking up, which left me with enough fresh (never refrigerated) milk for the first bottle of the day
- The 2nd and 3rd bottles were refrigerated milk from the previous day.
- Once per week, I would take a couple of bags out of the freezer and add a few bags to the freezer, to rotate the stash.
- Nursed whenever we were together.
From that perspective, most of the milk my kids were getting was direct from the source and the milk they were getting while I was away was mostly very fresh. I would expect that with most working moms and also in the case of most moms who need to supplement a bit with donor milk, that would also be the case. I would also expect that in ongoing donor situations, most people are trying to get fresh milk rather than frozen wherever possible.
I guess if that study is accurate, it comes down to whether a bottle of previously frozen breastmilk with slightly lower antioxidants or a bottle of formula with other potential risks, is going to be a better choice. Personally, I would opt with the occaisional bottle of previously frozen breastmilk. However, a parent who was planning to feed predominantly previously frozen breastmilk might have to make a different assessment/calculation, starting with getting a copy of the full study mentioned.
I just recently brought my daughter from home the NICU and in my experience, feeding tubes are very common. It burns a lot of calories for babies to eat from the breast or a bottle, and they don't usually have the muscle tone to eat on their own. They start with a tube and then will begin taking some feedings by bottle, slowly working up to all feedings. In my situation, feeding at the breast didn't happen until the day she was discharged -- since breastfeeding burned more calories than the bottle, they wanted to introduce the breast in the same way, one feeding a day and gradually increasing.
I think mixing tube feedings with feeding at the breast until the baby is exclusively breastfed would increase the length of the NICU stay.
I'm sorry I can't comment with the authority of Marsha Walker. I'm speaking as a mom, here. The "just one bottle" argument , that it won't hurt a baby, makes it sound as if all babies are the same. Too bad the nurses in the hospital felt that way when they gave my baby bottles at night, years ago when there were still central nurseries in Ontario hospitals. After all, what could it hurt? Just weeks of colic for him, that's what, and PPMD for me. Knowing him, one bottle would have done it. He is the most allergic of all my children, and he is nearly 30. He did NOT outgrow his milk allergy. For various reasons, only one of my babies got no formula in the early days, and he is the least allergic. By rights, he should be the worst, being the youngest of four. It makes my hackles raise when someone downplays the effects of one bottle of formula. You don't want to say that to a breastfeeding mom of allergic children unless you step back first. WAY back.
Where's the Facebook like button when you need it?!
I second this!!
Annie,
I understand that this is common, but it's one thing to tube feed b/c of what Lisa said above, and a totally different thing to choose a system of nourishment like that simply for the sake of avoiding nipple confusion. You know? And yeah, I get that a good LC can't solve everything (seven of them couldn't solve our problems, and I'd say that at least half of them would qualify as "good" or even "excellent"), but I also know plenty of preemie babies and babies who were supplemented b/c of other health issues who went on to nurse successfully. I guess it could be a decision left to the parents, but personally, I would find it really troubling if preemie moms were being encouraged to tube feed b/c it "might" help them nurse in the future. But then again, I have different feelings towards formula, so I can see how if someone believes that formula is really that detrimental, choosing to tube feed might be a rational choice....it's a tough one.
Helen,
I completely understand your anger - I'm sure I'd feel the same way. And actually, I sort of DO - just from an opposite perspective. My son was highly intolerant of milk (and soy) as well, but he suffered until he WAS given a bottle of formula (hypoallergenic formula, so that's a bit different, but still). He is slowly growing out of the milk intolerance, totally fine with soy, and has no other allergies or issues. Now, we also have 2 friends who EBF - nary a drop of formula (one is the awesome mom who I mentioned above who donated milk to her sister-in-law), ever; their sons both had similar issues to my son. They are still suffering from a variety of food allergies, asthma, etc. I would never in a million years ask them if they felt resentful of all the advice they got that BF would prevent these allergies from happening, b/c that would be insensitive... but sometimes I wonder.
I guess my point is simply that you totally have a right to feel the way you do, but please understand that it could be a stroke of bad luck, and not the formula. Or maybe it was the formula for your son... but that doesn't mean that every child will react the same way, you know?
This is a fascinating blog to me, not least because in the UK the choice simply isn't there. If you don't breastfeed your baby them the remaining option is to give formula. There are banks but they are accessible in such limited circumstances. It is also very hard to donate, the application process makes it hard for donors and its simply not valued. I would love to see this become a real option in this country.
One of the risks of infant formula not mentioned is the cost. Maybe I missed seeing it? Often, infant formula is given away free to new mothers. Mothers without incomes with no or few economic resources become trapped by this enticement because free formula ends at a certain point. Even the WIC Program does not give mothers in this program a full allotment of infant formula. Thus these mothers also have to expend their limited resources. Some mothers end up watering down formula causing water intoxication which can cause hospitalization and even death to an infant. In Louisiana after Hurricane Katrina one mother fed her preterm infant organic whole milk. The infant died, the mother was charged with murder and was convicted. Infant formula presupposes that mothers have easy access to affordable medical care, because babies get sicker, faster. Yet poverty, lack of resources, no health insurance creates a huge roadblock for some mothers to get the care that is needed for their infant. Thus, poverty and free infant formula is a deadly mix when access to medical care is difficult.
Politically, informal milk sharing, is a powder keg because it threatens the non-profit and for profit milk banking systems. These systems have overtly and covertly helped industry by sharing their donor milk with researchers and industries who are patenting human milk components. The possibility is that more regulation will happen. The convening of an FDA advisory meeting regarding donor milk benefit/risks seems ominous. Human milk has stem cells and that in my opinion trumps all. It means that there will be enormous corporate weight thrown to control a natural resource.
I am actually carrying for a gay couple, so it's especially important that I do this for them. :) I have heard of men inducing lactation, but I'm not sure they'd go that far!
Thanks so much for collecting the arguments and citations all in one place!
I breastfed one or two of my three children continuously for 9 years. I had chronic oversupply almost all of the time and needed to pump to help with overactive let-down. none of my boys would take breastmilk from a bottle or a cup. I desperately wanted to donate the gallons and gallons of breastmilk I pumped over the years but HMBANA (which governed the only milk banks in the U.S. at the time) refused milk donation from me because I was on medication they acknowledged (and Hale research confirmed) was harmless via breastmilk. I was so sad to dump so many gallons of milk I knew some mother needed and would have wanted. Thank goodness there are networks like Milkshare and Eats in Feets so mothers can decide for themselves. I am sure my milk, which fed my happy healthy boys, could have helped other children.
wow, Sarah. A blessing and a curse. I can only imagine your discomfort. Thank you for keeping up with it and helping so many others.
Lots of food for thought in the original post and the comments. I'm so glad both direct donation and HMBANA options exist. If anyone is interested here is the information on the http://www.fda.gov/AdvisoryCommittees/Calendar/ucm231418.htm" rel="nofollow">upcoming FDA advisory committe meeting. Its December 6 and they are taking into consideration any comments recieved through January 6.
I thought this was a very well-written post, and very well thought-out. I have a 10-month old and have extra milk that I have pumped. I've offered milk to several mothers (friends of mine) that I know are supplementing with formula, only to be turned down. It makes me sad that there is such a bias in this country (usa) about milk-sharing that they would rather buy formula and feed that to their babies than take milk that I am offering for free. I am healthy and eat the best diet that I can, and take no medications other than the occassional Tylenol. I would have no problems even wet-nursing another child or having my child nursed by someone else if I couldn't provide milk for her. Babies have a RIGHT to have human milk, and I couldn't deny that if it was in my power to provide it.
Right now the milk is just sitting in the freezer at my office...
My youngest son, who was exclusively breastfed until 10 months of age, would have had a significant amount of trauma to his gastrointestinal tract had he received even "just one bottle" of formula. He, like a growing number of babies I meet, suffered from infantile colitis and bled from his intestines when **I** consumed ANY amount of animal milk protein. He also proved intolerant to any gluten/soy I consumed. This being said, had he received a bottle of cow's milk-based artificial baby food he would have beld significantly (according to the many pediatric gatroenterologists he saw and I have since had the pleasure to work with and speak to) from his intestines and soy-based artificial baby food would have caused him a great deal of pain.
I think it is wonderful that you want to be educated but I think it is important not to be oblivious to the damage that **CAN** and **IS** caused to some babies when they are given "just one bottle." For a baby it can be horrifically traumatizing.
I am having a hard time finding donor milk for my son w/out a milk bank or costing a lot & frankly, I can't afford that. I've recently hooked up w/Eats on Feets and found 2 local (ish) ladies willing to help me provide my now 4 month old with breastmilk supplements instead of formula I despise him getting. I physically cannot make enough milk (diagnosed w/IGT w/my 2nd dd), so I am sure to give him every drop of the real stuff before I supplement. I know my family thinks it's weird of me to want donor milk for him instead of the free formula I could get for him, but I know that breast is definitely better than formula.
It's sad that people are so turned off by breastmilk (in the US some childcare centers treat it as hazardous liquids!) that the mere idea of sharing breastmilk is just way too "weird." I had a relatively easy time pumping extra milk when Donovan was little, but didn't know how to go about finding a place/way to donate it to. I'm hoping I'll have similar luck with supply when this new baby is born, and know of a breastmilk bank in town that I need to contact to see about the requirements for giving milk.
I am the mum of a highly allergic toddler (dairy, eggs, wheat, and in the early months, nuts also)- and EBF her. The key for us was identifying the allergies early, (skin prick tests at 3.5mths) and eliminating it from my diet. Best of both worlds.
It was good to see a post like this. I have been pumping exclusively for my youngest who was born at 23 weeks gestation weighing 1 pound 3 ounces for 14 months now. In the earliest months Quinn was too sick to "eat" anything except IV fluids so I just kept pumping and freezing and boy did I have a great supply. So much that Quinn could never catch up before expiration. So one of my best friends, who had recently adopted a preemie (33 weeker) used my milk (1/2 of the time the other half was preemie formula) till he was six months old! (I told you I made a lot!). Obviously we knew each other well and she knew about my health and lifestyle. What a great gift I was able to give! :)
Ingrid spoke to a possible typo. I think she is correct as it caused me pause and confusion on first read. It says that breastfed babies can be sensitized to cow's milk and create allergies. (paraphrasing). But this is listed as a risk of formula feeding so she and I think it should be bottlefed babies. That is the possible typo. Bottlefed or breastfed babies can be sensitized to cow's milk...
emily:
This is speaking to the risks of giving "just one bottle" to a breastfed baby. So a breastfed baby who is given formula supplements (rather than human milk supplements) risks being sensitized to cow's milk. I'm editing the sentence to make that clearer.
[...] (in comparison with the risks of formula feeding) that I’ve seen is in this wonderful post by Ph.D. in Parenting. It is really about whether or not mothers can be trusted to make the ‘right’ choice [...]
[...] Risks of Informal Breastmilk Sharing versus Formula Feeding. Mothers needing to supplement their breastmilk will be interested in this thorough comparison of [...]
[...] For a very good article on informal breastmilk sharing, by someone who focuses on breastfeeding (among most of the other challenging parts of young parenting) check out PhD in Parenting’s very subtle analysis. [...]
Thanks to this article I looked up Eats on Feets and I'm arranging a donation to a family adopting a baby. It is a small amount of milk but after having to throw away my previous freezer stash (it expired) I will feel very happy to see it not go to waste. If I am blessed with another nursing child in the future I will seriously consider pumping regularly to donate.
I'm late in replying, but I should state that I was not consulted before my daughter was fed from a bottle. I had expressed my wishes to breastfeed, but they weren't honoured, and there was certainly no discussion about using a syringe or other feeding method.
In fairness, she was born in 2005. I'm glad to hear from Mama in the City that attitudes are changing. The hospital that my daughter was born at is now seeking Baby Friendly status, and things have likely changed there, too. Although baby-friendly doesn't cover premature or ill infants, as I understand it.
Anyways, my point is that while there are alternatives to artificial nipples, it may not be possible in your NICU. And it can be asking an awful lot of a mother who just gave birth, especially if she's ill or it's her first child (as was the case with me - it took me a long time to initiate breastfeeding because I hemorrhaged and had surgery), to be on the ball in terms of sticking up for breastfeeding right out of the gate. This is why wholesale change is necessary, of the type Mama in the City is talking about.
I'm so glad to hear that change is coming. Having a baby in the NICU is hard enough, already, without having to contend with the added challenge of nipple confusion.
Thank you for sharing that Hannah. I'm so glad you've found a way to donate.
I had a preemie who was nipple confused. While I did eventually go on to breastfeed successfully, it was very difficult and involved a lot of tears and struggle. I wouldn't trivialize the experience, honestly. It was almost 6 years ago and I still remember how awful it was, and how awful I felt.
My daughter was never tube-fed. But in retrospect, I really wish they had considered that as an option instead of offering the artificial nipple. Or at least discussed it with me, and given me a chance to make an informed choice as a parent. Perhaps I'm saying this only because I haven't seen tube-feeding and I'm trivializing that, but I would go to great lengths to avoid nipple confusion, myself, having been through it.
[...] *For an excellent discussion of co-feeding, or ‘Informal Breastmilk Sharing’ look over here at PhD in Parenting [...]
I'm working on a story about milk banks, and was researching doing another story (or sidebar) about informal milk sharing for my job and came across this article. First off, great job getting all of this information and for all of your research.
There is a milk bank in my city and I'm hoping my story will help spread the word about donating milk etc. And hopefully more milk banks will be opened since they are so desperately needed.
On a personal note, I feed my daughter exactly how you explained in one of your comments. Fresh once a day, then refigerated from the day before (except for once a week when I rotate frozen). My frozen stash is dwindling little by little, but personally I don't feel comfortable with internet informal sharing. If it's someone I know--At church, a friend or someone with a child around her age, ok, sure, I'd probably consider it if she's open to letting me know more about her medical background, but some people don't want to give that information up.
Also, I agree that generally informal sharing is probably not as bad as people may think when they initially hear of it, but I don't think it's the same as wet nurses "back in the day." The way we all eat, the medications we take, and the way we live is different today, and while milk banks are expensive, I'd be more likely to trust the milk that's been processed through a bank. I guess I just wonder what the effects of informal sharing will show 100 years from now. Do we fully know all of the risks? We seem to know many for formula. Or is informal sharing in this day and age not the same as it used to be?
I just pray I can continue to nurse my daughter until she's a year so I don't have to make that tough decision.
[...] Risks of Informal Breastmilk Sharing versus Formula Feeding (PostRank 7.4) [...]
[...] ¿es más peligrosa la leche humana de otra mujer que la artificial? ¿Se toman las suficientes medidas de seguridad en los intercambios? ¿Qué lleva a unas mujeres a [...]
[...] ¿es más peligrosa la leche humana de otra mujer que la artificial? ¿Se toman las suficientes medidas de seguridad en los intercambios?¿Qué lleva a unas mujeres a [...]
[...] The update to their recommendations come just as a number of interesting developments are taking place in infant feeding in Canada. The Canadian Pediatric Society recently called for the creation of more human milk banks in Canada. At the same time, there has been an increase in informal milk sharing in Canada and a renewed debate on the relative risks of informal breastmilk sharing versus formula feeding. [...]
I have a beautiful breastfed 5mth baby girl... Against my better judgement I gave her a bottle of formula one time thinking that then her father could take her for a few hours(here and there) in the future if it worked (I have tried to pump, it is too painful and I can't get enough out)... Im not sure what happened to her but in the few hours after I gave her the bottle(around 4mths of age) she started to have some noticible differences, her legs and arms started to twitch suddenly with no rhyme or reason, it stopped after a few hours and has not came back since I have not given any more formula since then... but I wonder WHY that happened to her? also her stool became very hard and she was in distress trying to push it out of her (luckily it also passed within a few hours)... I told her father right there and then he will have to wait until she can have solids before he can take her for any length of time, he is very upset with me and still tries to tell me that because I smoke she should be having formula, but after that one instance I can even consider it...
your cons to bottle feeding are bullshit, bullshit, bullshit.
i bottle/formula feed my children by choice.
my children are very healthy. in fact, they are healthier than my best friends
kids that are/were exclusively breastfed. aside from the common cold, my kids
have never had any illnesses. Increase in lukemia. Give me a break.
If science = bullshit, I'll take bullshit.
Amen. I'm happy for the formula fed babies that grow up with medical issues that are few to none. But the risks are huge, and scientifically founded. It's not a lactivist conspiracy, my fellow human beings . . . it's a solid scientific truth that formula is a dangerous substance to give to babies - it should always be the last emergency resort.
I, too, have been dismayed by the lack of solid information on the long-term effects of medications in what we feed our babies. I have tried to sign up with the Wellbutrin registry, as I was on it during the second and third trimester and for four months after my son was born (I was suicidal, and had determined in the past that SSRIs made my condition worse instead of better, so it was definitely the best choice at the time). I would welcome the opportunity to participate in those long-term studies.
Similarly, we should be doing long-term studies on the effects of growth hormones and antibiotics in the milk that infant formula is made from. While some nursing mothers use OTC or prescription meds while nursing, nearly ALL dairy-based formula will have had at least antibiotics given to the cows. Long-term studies would be difficult, however, as there is little oversight or documentation of what medications might end up in what products.
It confuses me somewhat that moms who are very, VERY concerned about what chemicals might get into breastmilk are blasé about the myriad chemicals that are used to create infant formula. If one wants to avoid unknowns, it's far, far easier to do that with human milk.
How many studies have been done on the risks of the medications dairy cows are given (steroids, antibiotics to name some) on the infants that consume THEIR milk?
[...] written before about the rise in informal breastmilk sharing as an alternative to formula feeding. For some parents, giving their babies human milk is a preference — i.e. they just want to [...]
[...] dedicated to providing information on safety for those considering milk sharing. Also please see http://www.phdinparenting.com/2010/1...rmula-feeding/ for a balanced review of the risks. In summary, I think that the responsibility lies with parents [...]
[...] and does not sow the seeds for a public acceptance of the act of breastfeeding. We need greater awareness of the benefits of donor milk over infant formula, but at the same time, we need greater awareness of the benefits of breastfeeding or even a [...]