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View Poll Results: Breast feeding, my doctor told me my child would not get sick as often. Is this true for you?
I breast feed. 59 60.82%
My child is rarely sick. 53 54.64%
My child gets sick often. 2 2.06%
I bottle fed. 18 18.56%
My child is rarely sick. 16 16.49%
My child gets sick often. 3 3.09%
I bottle and breast fed. 18 18.56%
My child is rarely sick. 15 15.46%
My child is often sick. 2 2.06%
Multiple Choice Poll. Voters: 97. You may not vote on this poll

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Old 06-02-2007, 07:34 PM
 
Location: Hillsborough
2,825 posts, read 5,953,202 times
Reputation: 2620

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Irishmom said: and handing out formula samples doesn't make someone suddenly want to bottle feed instead of breast feed.

I said: And handing out formula samples by hospitals HAS been shown to be detrimental to breastfeeding rates. I can find the evidence on this for you too and get back to you. I'm surprised you aren't aware of this if you are an IBCLC as there has been a lot of talk about it for the last few years.

--------------------

Here is the evidence as promised. First, let me also say that healthcare professionals handing out formula samples goes against the WHO International Code of Marketing of Breast-Milk Substitutes which can be read here: http://www.who.int/nutrition/publica...de_english.pdf

Now, for the studies:

Bergevin Y, Dougherty C, Kramer MS. Do infant formula samples shorten the duration of breast-feeding? Lancet. 1983 May 21;1(8334):1148-51.

To determine whether advertising by infant formula companies shortens the duration of breast-feeding, we randomly assigned 448 breast-feeding new mothers to either receive or not receive a formula sample packet upon discharge from a maternity ward. These mothers, unaware of the study, were then telephoned 3 months post partum by a research assistant blind to the randomisation status. "Sample" mothers were less likely to still be breast-feeding at 1 month (78% vs 84%, p = 0.07) and more likely to have introduced solid foods by 2 months (18% vs 10%, p = 0.01). These trends became more significant in three vulnerable subgroups: less educated mothers, primiparas, and mothers who had been ill post partum. Our results suggest that infant formula samples may shorten the duration of breast-feeding and hasten the age at which solids are introduced.


Donnelly A, Snowden HM, Renfrew MJ, Woolridge MW. Commercial hospital discharge packs for breastfeeding women. Cochrane Database Syst Rev. 2000;(2):CD002075.

BACKGROUND: Exclusive breastfeeding until around six months of age, followed by the introduction of solids with continued breastfeeding, is considered to be the optimal nutritional start for newborn infants. OBJECTIVES: To determine whether the exclusivity and duration of breastfeeding is affected by giving mothers commercial discharge packs in hospital which contain artificial formula or promotional material for artificial formula. These packs are those which are commonly given to mothers on leaving hospital after giving birth (thus discharge packs). SEARCH STRATEGY: Comprehensive electronic search of the register of clinical trials maintained and updated by the Cochrane Pregnancy and Childbirth Group and CINAHL and MEDLINE. SELECTION CRITERIA: All randomised controlled trials with or without blinding to examine the effects of commercial discharge packs on breastfeeding. Participants: Consenting postpartum women who initiate breastfeeding while in hospital or immediately upon discharge. Interventions: Commercial discharge packs which contain free samples of infant formula or promotional material versus non commercial discharge packs (specifically those from which free samples of infant formula have been removed or have been replaced with e.g. breast pads) or no pack. Main outcome measures: The proportion of women breastfeeding at six weeks and 3 months (13 weeks) postpartum. Other outcomes: Rates of breastfeeding at other fixed time points between 0 and 6 months postpartum. DATA COLLECTION AND ANALYSIS: Data were extracted by one reviewer and checked by a second reviewer. MAIN RESULTS: Nine randomised controlled trials involving a total of 3730 women were analysed. The studies only included women from North America. The meta-analysis showed that when comparing commercial discharge packs with any of the controls (no intervention, non-commercial pack and combinations of these), exclusive breastfeeding was reduced at all time points in the presence of commercial hospital discharge packs. There was no evidence to support the conjecture that use of hospital discharge packs causes the early termination of non-exclusive breastfeeding. Where the introduction of solid food was measured, giving a commercial pack (with or without formula) reduced the time before solid food was introduced. REVIEWER'S CONCLUSIONS: The giving of commercial hospital discharge packs (with or without formula) appears to reduce the number of women exclusively breastfeeding at all times but has no significant effect upon the earlier termination of non-exclusive breastfeeding.


Frank DA, Wirtz SJ, Sorenson JR, Heeren T. Commercial discharge packs and breast-feeding counseling: effects on infant-feeding practices in a randomized trial. Pediatrics. 1987 Dec;80(6):845-54.

A randomized controlled trial was conducted to evaluate two interventions for prolonging the duration of breast-feeding in a multiethnic sample of 343 low-income urban women. One intervention compared research breast-feeding bedside counseling by a trained counselor, who also made eight telephone calls during the first 3 months of the infant's life, with the routine breast-feeding counseling provided in the hospital by nurses. The other intervention compared commercial discharge packs provided by formula companies with research discharge packs designed to be consistent with the WHO Code of Marketing of Breastmilk Substitutes. When infants were 4 months old, a telephone interviewer unaware of treatment status contacted 95% (324/343) of the women to determine the infants' feeding and health histories. Compared with routine counseling, research counseling delayed the first introduction of solid foods to the infant's diet (P = .03, one-tailed) but did not exert a statistically significant effect on breast-feeding by 4 months' postpartum. Women who received the research discharge pack, compared with those who received the commercial pack, were more likely to prolong exclusive breast-feeding (P = .004, one-tailed), to be partially breast-feeding at 4 months postpartum (P = .04, one-tailed), and to delay the daily use of solid foods in the infant's diet (P = .017, one-tailed). Among the women who received research counseling, the research discharge pack was associated with lower rates of rehospitalization of infants than was the commercial pack (1% v 14%; P = .014, two-tailed). We conclude that in high-risk maternity populations, commercial discharge materials for breast-feeding women should be replaced by materials consistent with the WHO Code.


Dungy CI, Christensen-Szalanski J, Losch M, Russell D. Effect of discharge samples on duration of breast-feeding. Pediatrics. 1992 Aug;90(2 Pt 1):233-7.

The breast-feeding patterns of 146 women who initiated breast-feeding during their hospital stay were evaluated to determine whether those women who received a hospital discharge package containing a manual breast pump breast-fed their infants for a longer period of time than did women who received a discharge package containing an infant formula. Women were randomly assigned to receive either a specially prepared pack containing a manual breast pump but no infant formula or a commercially available infant formula package. The women were interviewed in the hospital and by computer-assisted telephone interviews at 2, 4, 6, and 8 weeks postdischarge. Information obtained included infant-feeding practices, sociodemographic characteristics, and attitudinal data. Follow-up interviews were completed for nearly 85% of eligible women at each time period. Women who received a discharge pack containing a breast pump but no infant formula continued exclusive breast-feeding for a greater number of weeks (mean = 4.18 weeks) than did women receiving infant formula in their discharge package (mean = 2.78 weeks) (P less than .05). Also, women who indicated that ease of nighttime feeding was an important consideration were more likely to breast-feed over the entire 8-week period if they received the breast pump rather than infant formula (P less than .05). The conclusion is that an easily implemented, low-cost intervention, the inclusion of a breast pump in discharge packages, may increase the duration of breast-feeding.


Perez-Escamilla R, Pollitt E, Lonnerdal B, Dewey KG. Infant feeding policies in maternity wards and their effect on breast-feeding success: an analytical overview. Am J Public Health. 1994 Jan;84(1):89-97.

OBJECTIVES. The purpose of this review is to examine the plausibility of a causal relationship between maternity ward practices and lactation success. METHODS. Studies were located with MEDLINE, from our personal files, and by contacting researchers working in this field. Of the 65 studies originally reviewed, 18 met our inclusion criteria (i.e., hospital-based intervention, experimental design with randomization procedures, or quasi-experimental design with adequate documentation). RESULTS. Meta-analysis indicated that commercial discharge packs had an adverse effect on lactation performance. The impact of early mother-infant contact on lactation success was unclear. Rooming-in and breast-feeding guidance in a rooming-in context had a beneficial impact on breast-feeding among primiparae. Breast-feeding on demand was positively associated with lactation success. In-hospital formula supplementation of 48 mL per day was not associated with poor breast-feeding performance. CONCLUSIONS. Hospital-based breast-feeding interventions can have a beneficial effect on lactation success, particularly among primiparous women.


Caulfield LE, Gross SM, Bentley ME, Bronner Y, Kessler L, Jensen J, Weathers B, Paige DM. WIC-based interventions to promote breastfeeding among African-American Women in Baltimore: effects on breastfeeding initiation and continuation. J Hum Lact. 1998 Mar;14(1):15-22.

We evaluated the single and combined effects of introducing a motivational video and peer counseling into four matched WIC clinics on breastfeeding initiation and continuation at 7-10 days among African-American WIC participants. Of the 242 women with complete data, 48% initiated breastfeeding, but only 31% were still breastfeeding at 7-10 days. Initiation was associated with cesarean delivery, infant feeding instruction, no artificial milk discharge pack, attending the peer counselor only-intervention site, and intention to breastfeed. Continuation was influenced by infant feeding instruction, no artificial milk discharge pack, and intention to breastfeed. Overall, trends toward a positive impact of the breastfeeding promotion activities were evident but weak, and largely gone by 7-10 days postpartum.

Romero-Gwynn E. Breast-feeding pattern among Indochinese immigrants in northern California. Am J Dis Child. 1989 Jul;143(7):804-8.

A sharp decline in the rate of breast-feeding was documented among Indochinese mothers who migrated from Cambodia and Laos to a city in northern California. While 97.0% of the mothers breast-fed their last infant born in Indochina, only 26.1% and 22.4%, respectively, breast-fed their first and last infant born in the United States. Furthermore, only 3.8% of the mothers who were pregnant at the time of the study intended to breast-feed. The duration of breast-feeding decreased from an average of 20.4 months for the last infant born in Indochina to 8.7 months for the last infant born in the United States. After controlling for several sociodemographic variables, only formula samples distributed at hospital discharge had a significant association with formula feeding (odds ratio, 2.02). However, data on intention to breast-feed suggested that a clear cause-and-effect relationship may not exist. Factors related to cultural traditions and acculturation are offered as possible explanations for the decline in breast-feeding. Breast-feeding education for mothers and training for health professionals is recommended.
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Old 06-02-2007, 08:07 PM
 
Location: Hillsborough
2,825 posts, read 5,953,202 times
Reputation: 2620
Quote:
Originally Posted by deerislesmile View Post
Are you actually saying that formula is to a baby as chocolate is to a diabetic? That formula is actually harmful to a baby? I'll give you second best to breastfeeding, but I disagree strongly with you that it is harmful to a baby. If so, we should be reporting all non-bfers to the child welfare department for abuse/neglect. That would teach them, huh?
I am not saying that formula is poison, but it is potentially harmful to babies if you consider the increased rates of infection, hospitilization, and later medical effects. I don't accept the argument that breastfeeding is "better" than formula feeding because breastfed babies have fewer illnesses. That puts formula feeding as the norm, and breastfeeding is the biological norm. Rather, babies who are not breastfed are at an increased risk for these problems. So yes, I do think it is detrimental to babies. Sure, babies can survive without being breastfed. They can do well and be healthy. But they are at higher risk from that choice of a large number of chronic and acute illnesses.

Quote:
Again, I strongly disagree with your argument that formula is as potentially harmful to babies as not being securely harnessed in a safety seat or as harmful as a disease like diabetes. Show me some studies, facts, or reliable research that prove that formula actually harms an infant, which is what I hear you saying repeatedly. Formula might be less than optimal, but hardly detrimental.
Did you read the many many studies I just posted above? They all indicate higher risk due to formula feeding. Lots and lots of studies, facts, and reliable research. Just like you can say that your kid is perfectly healthy being formula fed, someone else can say that their kid is perfectly safe without being in a car seat. Until they aren't. The WHO estimates that 1.5 million children die each year because they are not breastfed. (See UNICEF) Separately, a report in the Lancet estimates 1.3 million children's lives could be saved by breastfeeding, the top recommended intervention for preventing child death.

Of course breastfeeding and car seats are not the same thing. But they both have negative health and safety effects, not positive ones, and not neutral ones. Healthcare professionals should be promoting healthy behaviors, not the opposite. And they shouldn't have to feel like they are going to make people feel guilty, they should feel like they are educating their patients.

Quote:
Detrimental to breastfeeding rates, not actual detrimental to babies, right?
Same thing, as per above.

Quote:
I don't really approve of the "freebies" given at the hsopital because they seem to endorse one brand over another, but I know my clients have found them helpful. Some have recieved a formula bag with free formula samples and bottle samples, and others have recieved a bfing pack with pads, lotion, and a water bottle. Both bags have brochures and informational publications from area parenting agencies, including WIC and LLL, in addition to the corporate stuff. And of course, they all have the option to not take the bag at all.
I addressed the story about the discharge bags in my above post. There is ample evidence that discharge bags with free formula are detrimental to breastfeeding, and yes, therefore detrimental to babies.
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Old 06-02-2007, 08:20 PM
 
Location: Hillsborough
2,825 posts, read 5,953,202 times
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Quote:
Originally Posted by deerislesmile View Post
I would say that the information about breastfeeding is adequately made available to most new mothers in one form of delivery or another.
I think we would disagree on what we would call "adequate" then, based on the reasons I have heard people give for not breastfeeding.

Quote:
I'm interested in what your definition of "strongly endorse" is, ADVentive. I'm thinking of my own interaction with my clients. If I have given them all of the information about their choices, and they choose to bottle feed, what then? If they looked at the healthcare professional and stated "We have looked at all of the information and decided that we are going to bottle feed.", what should be the response at that point?
Well, I think about what my ped says to me if I tell her that I don't want my daughter to have X vaccine. She wants to know why. If she doesn't think my reason is very good, she tries to convince me by telling me how important X vaccine is and what the risks are if my daughter doesn't get it. If she feels really strongly, she might even refuse to keep us as patients and ask us to find another doctor. However, if she hears my reasoning and thinks that I have made an informed choice for my family while knowing the risks, then she will say okay, that is a good reason. I would say that my ped strongly endorses on-schedule vaccination. I wish that my ped strongly endorsed breastfeeding, but in reality, she really only mildly endorses it.

Quote:
What if they come in for the 2 or 3 week postpartum checkup and have already gone to a bottle? Is there anything to say at that point?
I think that at that point it's too late for most people. Sure, it's possible to relactate - people do it if they are really motivated. But in general, I think this is education that needs to come before the patient switches to formula.
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Old 06-02-2007, 08:46 PM
 
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Adventive wrote- The WHO estimates that 1.5 million children die each year because they are not breastfed.

The children did not die because they were given formula, though. They died because the formula was mixed with unsanitary water, or because the mothers were not educated on how to use the formula- including food safety issues/refridgeration, and how to mix it in correct proportion. Many uneducated mothers will add extra water and think that it is still as nutritious. So it's not the formula that kills the babies, but the improper use of formula. I agree that breast feediing is the best foods for infants, but I really don't think that bottle feeding is any worse than choosing to have kids if your over 35, or if you don't have a college education, and I'm sure there are all kinds of studies that would show that those things probably have a negative effect on lifelong health of infants, too.
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Old 06-02-2007, 09:27 PM
 
Location: Between Here and There
3,684 posts, read 10,840,329 times
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Quote:
Originally Posted by deerislesmile View Post
I am kind of lumped in with health care professionals- I teach budgeting, cooking, and nutrition skills to families. Most of my clients are young families or pregnant moms. We teach them about prenatal nutrition, as well as a lesson on breastfeeding and another on bottle feeding. We also offer education about breastfeeding support groups and make referrals to lactation consultants and maternal health care nurses, as well as parenting support groups. Most, if not all, of my mothers are also recieving WIC, so they also get educated there about the choices that they have. In addition, many are educated about their choices by their OB/GYN or midwife or nurse on their usual prenatal visits. I would say that the information about breastfeeding is adequately made available to most new mothers in one form of delivery or another.

I'm interested in what your definition of "strongly endorse" is, ADVentive. I'm thinking of my own interaction with my clients. If I have given them all of the information about their choices, and they choose to bottle feed, what then? If they looked at the healthcare professional and stated "We have looked at all of the information and decided that we are going to bottle feed.", what should be the response at that point? What if they come in for the 2 or 3 week postpartum checkup and have already gone to a bottle? Is there anything to say at that point?
This is what I was talking about! They get all the information, all the education and they want to bottle feed anyway. I don't think that giving them samples in the hospital of formula makes any difference, since most mothers come in and have already decided. Some will allow us to put the baby to the breast don't like it and stop, and others are adamant that they don't even want to try. You can't force women to breastfeed and I don't think you should make them feel bad for it. I won't do that, no matter what the health benefits are.
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Old 06-02-2007, 09:35 PM
 
Location: Between Here and There
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Originally Posted by ADVentive View Post
I think we would disagree on what we would call "adequate" then, based on the reasons I have heard people give for not breastfeeding. Just because you don't like the reasons doesn't mean they weren't educated on the matter. Women have preconceived notions of what they will or won't do when they become mothers. Occaisionally you can at least get them to try something different, but for the most part most have made up their minds before they come in to have the baby.

Well, I think about what my ped says to me if I tell her that I don't want my daughter to have X vaccine. She wants to know why. If she doesn't think my reason is very good, she tries to convince me by telling me how important X vaccine is and what the risks are if my daughter doesn't get it. I do this with my patients, it just doesn't always change their minds.

If she feels really strongly, she might even refuse to keep us as patients and ask us to find another doctor. I have never encountered a physician like this and I would never do that to one of my clients. However, if she hears my reasoning and thinks that I have made an informed choice for my family while knowing the risks, then she will say okay, that is a good reason. I would say that my ped strongly endorses on-schedule vaccination. I wish that my ped strongly endorsed breastfeeding, but in reality, she really only mildly endorses it. Although you don't think the reasons you've heard for not breastfeeding are good enough, they are very good to the people who decide not to do it. It is not our job to judge, just to inform and support whatever decision is made.
ADVentive - I know you mean well, but so do I. My first responses to you were referring to people who can't breastfeed because the post you were questioning of mine was also referring to those who can't breastfeed. But I still think mothers need to support one another no matter how they decide to feed their children, it's not the most important thing that they will ever do. I also think that health care professionals need to support their clients no matter what they choose to do. It is a choice, irregardless of which is better it's still a choice. You can not force anyone to do it.
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Old 06-02-2007, 10:34 PM
 
743 posts, read 2,038,280 times
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Originally Posted by irishmom View Post
LMAO!! I can just picture you up in the middle of the night looking for a sharpie...LOL I have to say I'm soooo glad those sleepness days are over...now I'm just battling the hormone insomnia of perimenopause...41 and counting.
Hey, I'm 41, too....is this the time for perimenopause? If hormones rage during that time, maybe that explains why I'm sometimes known around here as the "tsunami mommy"

Seriously....I always thought menopause was more in your 50's.
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Old 06-02-2007, 10:58 PM
 
Location: Between Here and There
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Originally Posted by beth ann View Post
Hey, I'm 41, too....is this the time for perimenopause? If hormones rage during that time, maybe that explains why I'm sometimes known around here as the "tsunami mommy"

Seriously....I always thought menopause was more in your 50's.
Perimenopause generally starts about 10 years prior to menopause...the average age of menopause is 52...so yeah it starts now.
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Old 06-02-2007, 11:24 PM
 
743 posts, read 2,038,280 times
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Originally Posted by irishmom View Post
===. I don't think that giving them samples in the hospital of formula makes any difference, since most mothers come in and have already decided. =.
I think it can make a definite differnce.....this is a scenario I've seen personally and/ or heard of repeatedly...mom breast feeds in hospital w/ or w/o LC successfully....mom comes home 2 days later after milk has "come in"....mom soon has painful engorged breasts...baby has problem w/ latching-on to engorged breasts.....mom is hormonal and crying....not enough we diapers....baby is crying....baby is hungry....mom is understandably, overwhelmed....mom changes sides, changes positioning, uses pillows...baby is still crying...after many attempts and maybe even an hour or so, mom (or dh) goes for the free formula....baby stops crying....mom stops crying....the next feeding mom tries again to bf, but has some posisitoning issues....mom has had only 4 hours of sleep....mom has sore nipples due to incorrect latch-on....baby and mom are both crying again....mom uses free formula again....the next day the mom tries to bf once again and the baby can't latch on and the cycle continues until mom's milk supply is negatively affected. This is how a mom with a desire and intention to bf can end up not bf.

The first week of bf is undeniably, the most challenging, even for moms who have bf previous children. If many women (those who wanted to bf) only had the adequate support and and hands-on (boy, that sounds funny) instruction, it would have made a world of differnece.....there is a "hump" to get over, but once you get over it, it is almost always smooth sailing from then on.

I think free formula samples should not be given to anyone. If you are breast feeding, then what's the point? If you are bottle feeding, then go to the grocery store and buy it, just like any other food.

I do, however, know several women (friends, acquaintences and relatives) who said, during pregnancy, 'I'm going to try breast feeding....I hope I can do it". I have a huge problem w/ this premise....what has happened in our society where women are going into breastfeeding thinking they will fail? I'm not blaming the women, I'm saying there needs to be huge public service announcements and change in societal attitudes through education and facts.
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Old 06-02-2007, 11:25 PM
 
743 posts, read 2,038,280 times
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Originally Posted by irishmom View Post
Perimenopause generally starts about 10 years prior to menopause...the average age of menopause is 52...so yeah it starts now.
What are some of the symptoms and signs of it?
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