One of the surprising ways to boost breast-feeding rates among new moms may involve formula, according to the latest research.
With
a growing body of evidence supporting the benefits of breast-feeding
for both mom and baby, public health experts celebrate each time a
hospital receives "Baby-Friendly" status, which indicates the facility
endorses steps that encourage breast-feeding such as not separating moms
and babies after delivery and offering formula only if it's deemed
medically necessary.
But a small study published in the journal
Pediatrics suggests that giving newborns a little bit of formula
actually helps boost breast-feeding rates. The formula primer may give
moms the assurance they need to keep pursuing breast-feeding, say the
study's authors.
Not surprisingly, many breast-feeding experts are
taking issue with the findings, worried the results may undermine
public health messages that breast milk alone is best for babies.
The
study, from University of California, San Francisco (UCSF), followed 40
newborn babies who had lost at least 5% of their birth weight by the
time they were 36 hours old. The American Academy of Pediatrics (AAP)
notes that weight loss in an infant's first days is typical as they
become accustomed to feeding; average weight loss is about 7%.
But
lead author Dr. Valerie Flaherman, an assistant professor of pediatrics
and epidemiology and biostatistics at UCSF, focused on this group since
other data suggests that infants who lose this much are more likely to
lose more weight; when babies drop 10% of their birth weight,
pediatricians become concerned that the infants may be at risk of other
health problems.
For the trial, Flaherman and her colleagues
assigned half the babies a couple days of birth to receive two teaspoons
of formula after each breast-feeding, via a syringe so as not to
encourage "nipple confusion" in which a baby has trouble transitioning
between breast and bottle. Mothers were instructed to discontinue the
formula supplementation once their milk supply appeared, which generally
takes two to five days. The other half were exclusively breast-fed
unless the doctor ordered formula.
TIME.com: Breast-milk donors come to the rescue of a new mom with breast cancer
At
one week of age, 10% of the formula group was still using formula in
some way as part of their feeding strategy compared to 47% of the group
originally assigned to breast-feed but who added formula. And at three
months, 79% of the formula group was exclusively breast-feeding,
significantly more than the 42% of moms in the group originally
instructed to breast-feed.
Though it might seem counterintuitive,
Flaherman suspects that introducing a small amount of formula early on,
then withdrawing it, helped moms feel secure that their babies weren't
hungry and losing weight in their first days of life. That likely gave
them confidence to go on breast-feeding exclusively.
"Using that
little bit of formula earlier really seems to have had a big effect on
whether babies are getting formula at one week," she says. "We wanted to
try to find an early intervention we could do with these babies and
moms to help them continue breast-feeding. I was surprised the effect
was this big."
In the U.S., most moms start off breast-feeding,
but only 40% are still doing so at six months and just 20% make it to
one year, which is the milestone that the AAP recommends at a minimum.
Not everyone is convinced that using formula in this way, however briefly, is going to increase that percentage.
"This
study goes against everything that's been published for several years
now from very reliable clinicians and researchers about the potential
hazards of supplementing exclusively breast-feeding babies with
formula," says Dr. Kathleen Marinelli, an associate professor of
pediatrics at the University of Connecticut School of Medicine and the
chair-elect of the U.S. Breastfeeding Committee.
"They're flying
in the face of years of research here and doing so rather glibly,
stating that this is the new way to look at things."
Tanya
Lieberman, a lactation consultant who writes about scientific research
for breast-feeding advocacy organization Best for Babes, says she's "a
little confused" by the results. "We know what works to increase
breast-feeding exclusivity and duration and we've known it for 20 years.
That includes no supplementation unless medically necessary."
Lieberman
says that the findings may have been affected by the attitude of the
women themselves, who said they wanted to exclusively breast-feed but
were also open to using formula. Mothers may also be under some
misperceptions about how much milk newborns need. "Babies don't need
large volumes of milk in the first few days," she says. "They are fine
until their mother's milk comes in."
Flaherman says the study's
results are not necessarily applicable to all babies. "This isn't
something we think all people should do," she says. "It is just a
potential tool for moms to consider using if they think it might be
helpful."
She also says that the ultimate goal of the study was to
find a way to help more mothers breast-feed, and to do so for as long
as possible to help their babies. "It's kind of crazy that only 20% of
people reach the recommended duration of breast-feeding," says
Flaherman. "Different approaches to supporting breast-feeding may work
better for different people." And for some mothers, that may even
include a little bit of formula.
No comments:
Post a Comment