In January of this year, Mary Fewtrell & co published an opinion piece in the BMJ (British Medical Journal) questing the evidence behind the WHO’s recommendation of exclusive breastfeeding until 6 months. This caused newspapers and online news sites to come out with headlines like:
Six months of breastmilk alone is too long and could harm babies, scientists now say — The Guardian
Too much breastfeeding ‘puts children off greens’ — The Independent
Weaning before six months ‘may help breastfed babies’ — BBC News
Parenting forums everywhere rapidly filled with threads, everything from “omg am I killing my baby by exclusive breastfeeding?!” to smug “I told you to start on purees at 8 weeks” from a generation of older parents. Suddenly people were telling all and sundry that the Government guidelines on weaning were changing and that mums should take note. A cursory glance at mumsnet just now and I count 2 references to the BBC article in one topic (posted on this weekend… not an old thread by any stretch of the imagination) to support early weaning.
The piece was heavily criticised by doctors, midwives and professors in the rapid response section of BMJ; by Baby Milk Action; by LLL GB (La Leche League GB); by lactivists and breastfeeding supporters everywhere. (There are some fantastic responses on the rapid response from people much smarter than me. Definitely worth a read.)
So why is it that, 6 months on, when an actual study featuring our controversial friend Fewtrell was published in the journal of the American Academy of Pediatrics (and elsewhere) confirming the adequacy of breast milk and exclusive breastfeeding for 6 months (emphasis my own):
Results of this prospective study reveal that when mothers are well supported and follow the World Health Organization recommendation on breastfeeding, milk intakes are high and increase over time, and there is adequate energy intake, normal infant growth, and no marked changes in breastfeeding practices. This new empirical evidence on adaptations during exclusive breastfeeding should help health professionals promote the initiation, duration, and exclusivity of breastfeeding.
…it gets nary a mention in the media? This is an actual study, using actual sciencey bits, and isn’t just the opinion of a baby-food industry puppets. And yet, no BBC telling us that in reality, breastfed babies are ok on just breast milk; no Guardian telling us that actually, 6 months of breastfeeding is just bloody fine.
Oh yes, that’s right, because telling mums they’re doing well (instead of admonishing them for yet another failure) wouldn’t boost sales, would it?
11 Oct at 5:58 pm
Exactly! As is with all other matters there will always be busybodies shoving their oars in and telling people how to do stuff. My advice (from someone who BF’d her own and never had a problem with any bar one that refuses to eat any veg at all) is use your own judgement.
If your baby seems to be happy with just boob, then stay as you are. Surely that is half of what the phrase ‘Demand feeding’ is all about? Your own baby will let you know when he or she is ready for something more than just milk and nobody else should have the right to interfere with a mother’s decision about the welfare of her little one.
Don’t listen to the crud that so called ‘experts’ dish out – 99% of them have neither had kids of their own, or BF a single baby let alone several. If in doubt, ask your friends with babies for support and advice and the support network of breastfeeding mothers past and present and only seek ‘professional help’ when you have no other alternatives.
I fed my lot without any ‘help’ from health visitors and most of them self weaned and eat plenty of healthy stuff too (even if Jem does eat far too much cake ;) )
11 Oct at 6:11 pm
I hated those headlines. Drove me insane. Just because one person questioned the recommendation doesn’t mean the media should spout damaging headlines like that. (But… I guess that’s what they do, right? Ugh.)
11 Oct at 8:10 pm
(“heavily criticised by doctors, midwives and professors” link currently broken.)
12 Oct at 7:45 am
WordPress ate the ‘http://’ (that’s my excuse and I’m sticking to it!)
12 Oct at 1:12 am
As a member of the scientific community, this reminds me of the global warming dispute. Here’s a good article from Australian scientists that I think that you’ll like. If you want to show that someone’s research is baloney and not science, you can follow the steps that the author of the linked article took.
Check for other similar publications in refereed journals. Check that the publications are in relevant journals. For health related issues, the PubMed database should be a good database to search through.
Check for funding sources. Be slightly suspicious if the article doesn’t outright say where the funding came from. But not all journals list this. Most professors will list where their funding comes from. If it’s corporate funding, sometimes there is a need to be suspicious. Government funding generally should not be suspicious.
I’ve never heard of this being an issue, but you could also check who reviewed the paper before it was published.
I haven’t the time and energy to do all that, but this case was easy. The study was funded in part by companies that make formula and peer reviewed externally, rather than the journal editors. Case and Point.
Finally, if an article makes it to a scientific journal, then it’s supposed to be legitimate and more than just an opinion. (Just being a bit nit-picky…) However, as shown by the global warming debate, the peer review process does not catch everything.
12 Oct at 7:48 am
Thanks – quite a few people before me had already highlighted that they’d received funding from formula companies which in itself is dodgy, but I don’t know enough about the sciencey stuff to know about peer reviewing etc.
Re: opinion/article – it was in the opinion section of the BMJ rather than submitted as a journal piece, which is why it’s so bloody annoying that the press took it and ran it as a story. I think the BMJ press office who pushed it in the first place should be ashamed. But of course, that wouldn’t help the BMJ either.
12 Oct at 4:16 am
I am so sick of the tactics used by the baby food industry. It’s ridiculous the way they use fear mongering to get people to buy their products and even more ridiculous that people actually fall for it. The human race survived just fine for thousands upon thousands of years before Carnation was unleashed upon the world.
Formula is wonderful for mothers unable to breastfeed, but otherwise…
13 Oct at 9:53 am
This kind of thing is SO widespread. The internet is making it worse, people post and re-post others’ reports and interpretations of “evidence” without referring to the source themselves and the general public accepts it as fact. The media should have some sort of responsibility to report and critically appraise these studies accurately.
15 Oct at 10:46 pm
I wonder what formula TV ads are like in the UK. Since you brought up this issue I have paid more attention to the ads in my country, and I noticed that they always show a mother breastfeeding a baby as well as a notice (albeit rather small) which states that the mother’s milk is a better option, if possible. The ad is STILL alluring or else why bother, but at least it’s not downright offensive or moronic.
16 Oct at 12:44 pm
In the UK they have to show those notices – it’s a legal requirement.
The formula adverts are sneaky. There’s an Aptimil one here that shows a woman breastfeeding her kid. She looks tired, hair not so great, it’s cold and wintery outside. The voiceover talks a little about breast milk and then says “WHEN you’re ready to move on from breast milk” (not IF, which gets my goat) and then shows the same mum with a radiant glow, it’s summer, the sun is shining etc. Very subtle, but I guess they pay a lot of money to look like they’re not actively bashing the boob.
17 Oct at 11:13 am
Oh, Jem. By now you must know that people just can’t do things properly.
Mothers don’t know how to feed, dress, entertain or educate their children.
Women don’t know how to dress; they think they’re able to wear high heels (http://shakespearessister.blogspot.com/2011/09/there-are-just-so-many-ways-to-be-bad.html) or that their cleavage isn’t a terrible offense (http://www.cbc.ca/news/canada/british-columbia/story/2011/10/06/bc-david-schrick-christy-clark-cleavage.html).
All fat people are stupid and completely lack self control, so they eat junk food all the time (and really all the time, non-stop when they’re awake).
People also need the media to tell them how, when and who to date, with details of whether this or that is appropriate on the first date, the second date, etc.
And, of course, women wouldn’t be able to give birth if it weren’t for doctors or nurses. I mean, it’s not like your body is programmed for the job. You need someone to tell you when to push, when to breastfeed, etc.
Basically, YOU’RE DOING THINGS WRONG and you should thank the media for educating you in the Ways of Life.
19 Oct at 3:38 am
Your comment and links just made my whole day. Amen!