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"All that I am or ever hope to be, I owe to my angel Mother"Abraham Lincoln |
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Rachel Allen"What a great site! I love it! I think changing the public perception of breastfeeding to show mums they can stay stylish and still breastfeed is much needed to fill a support void in Ireland. Culturally it is our public perception which holds so many people back. |
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Domini Kemp
“No chef, food company or scientist can make food as perfect for your baby, as you can. Yes, breastfeeding takes time, but the results are worth it. Your baby’s health is undoubtedly improved and it’s great for getting you back in shape. |
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The Formula formula.What’s so wrong with formula I hear you say? Well, yes, plenty of girls of our age were brought up on formula, and “sure aren’t you grand!”? Yes, we concede that this may be so... but there was also an era where cigarettes were thought to be “grand” too! It's just that we know better now... and it’s hard to go against that.
And Im afraid we cant really say “there’s nothing wrong with formula, it's just that breastmilk is better”... Because it’s a much stronger argument than that!
Breastmilk substitutes can only ever be exactly that – a substitute for the real and best thing… a bit like a fake designer bag!
And now for the science stuff….
Although the allowed maximum and minimum levels of ingredients for breastmilk substitutes are laid down by statute (infant breastmilk substitutes and follow on regulations 1995), precisely what goes into breastmilk substitutes (formula) is increasingly being questioned….
Until 1984 recommendations for the amounts of calcium, phosphorus and magnesium were too high, because they were based on research from 1953. other important nutrients such as zinc and cysteine were absent, as of yet thought not to be necessary.
The same year, 1984, was the first time that taurine, essential for myelinating nerves, was added to breastmilk substitutes. (Minchin 1985)
The contents of breastmilk substitutes(formula) are constantly changing as per latest research, so that the infants receiving formula are susceptible to be deficient in whatever nutrients are deficient in formula at that time period.
And adding the nutrients in isn’t necessarily the answer. Too much iron is still found in formula as compared to breastmilk; about 20 times the concentration that is found in breastmilk (it cannot be well absorbed without human lactoferrin, only found in breastmilk).
Components of breastmilk and formulaEbrahim summed up the differences (RCM Successful breastfeeding)
“infants who are fed artificially are biologically different from those who are breastfed. Their blood carries a different pattern of amino acids, some of which may be at levels high enough to cause anxiety. Their composition of fat is different. They are fed a variety of carbohydrates to which no other mammalian species is exposed in neonatal life”. Sounds little alarming to us !
Individual components of milkProteinHuman milk has a lower concentration of protein than any other animal (Akre, J. 1989. Infant Feeding: the physiological basis.). The higher protein available in cows milk or other breastmilk substitutes confers no biological benefit to humans, and actually places the infant at risk of hypernatraemic dehydration in situations of increased fluid loss (Walker).
The human whey proteins consist mainly of human alpha lactalbumin, an important component of lactose synthetase. The bovine (cow) version of this whey protein is capable of provoking atopic (allergy type) responses in prone infants. (2-7% of infants). Another bovine whey protein, bovine serum albumin, has been implicated in the development of IDDM (insulin dependant diabetes) as described by Monte et al in 1994, and may be the reason that formula fed infants have an increased risk of developing this disease.
Human milk contains other whey proteins called lactoferrin, immunoglobulins and lysosyme... which all protect against disease, and protect against E coli, Salmonella and Candida infections.
Per 100 ml Energy (kcal) Protein (g) Fat (g) Carbohydrate (g) Cholesterol (mg) Lactoferrin Cysteine:Methionine ratio | Breastmilk 70 0.9 4.2 7.3 16mg (important in infancy) Yes 1.3:1 | Aptamil 67 1.5 3.6 7.3 Nil Trace 0.6:1 |
Taken from RCM 1994
Free Amino AcidsBreastmilk has higher levels of cysteine and lower levels of methionine than cow’s milk (much lower ratio). This has very important implications in a babys’ optimal brain development (? May be why breastfed babies have a higher IQ – see 100 reasons).
CholesterolCholesterol appears to play a role in myelin syntheses of the growing nervous system. Formula contains none. (Jooste 1991)
Fatty acidsMore than 100 fatty acids have been identified in breastmilk, many of them in the form of long chain polyunsaturated fatty acids which are particularly important in brain myelination. The problem with formula is that the baby may not be able to convert precursors of these fatty acids into their biologically active form as fast as is needed for the developing brain and retinal membranes. Preterm formula fed babies are at a particular disadvantage as they find it most difficult to convert these acid precursors.
CarbohydrateThe carbohydrate component of breastmilk is mainly lactose. Lactose is a sugar found only in milk and appears to be a nutrient specific to infancy: the enzyme lactase is found only in the young of mammals except humans, in whom it may persist into adult life, particularly in Europeans.
As well as providing about 40% of the energy needs of the infant, lactose facilitates calcium and iron absorption and encourages Lactobacillus b. to colonise the gut. This is further encouraged by the presence in human milk of bifidus factor, which is absent in bovine milk/ formula. The pH is subsequently kept low and this discourages pathogenic infections such as E Coli and Salmonella in breastfed babies.
Minerals/ Trace ElementsMineral concentrations are much lower in breastmilk, and match the baby's metabolic capabilities. Calcium is better absorbed from breastmilk than bovine milk.
The high phosphorus content of cows’ milk has been reported to increase the risk of hypocalcaemic tetany in the 1st 10 days of life by a factor of 30. (Specker et al).
Copper and other trace elements are present at higher levels than in cow’s milk. Copper defieciency only occurs in artificially fed infants.
Appropriate levels of zinc and copper, the transfer factor, lactoferrin, and the low pH of the GI tract combine to unlock the lactoferrin molecule, allowing up to 70% of the available iron to be absorbed. The iron in formula is in the form of an inorganic salt, only 10% of which is absorbed. (Akre 1989)
Preparation and manufacturing worries:All breastmilk substitutes have the potential for inadvertent excesses of deficiencies during the manufacturing process. There is also the danger of accidental contamination. Documented cases include contamination with aluminium, iodine, halogenated hydrocarbons and bacteria. (Walker 1993). The possibility of deliberate contamination also exists, particularly prevalent in this “age of terrorism”. Formula powder has also run into problems with interaction between the can and its contents, particularly with lead and plasticisers (Walker 1993).
But the concern doesn’t end with manufacturing. Buying formula may be done inappropriately, particularly if the purchaser does not (or cannot) read due to illiteracy or language problems. It also becomes a problem in areas of contaminated water supplies… (and not just in the developing countries – we had our own problem with Cryptosporidium in Galway).
The cost of formula may cause people to try to save money by overdiluting to “make it go further”, or over concentrating to make babies sleep (ill-founded). Over concentratin formula can cause obesity, intestinal obstruction, hypernatraemia and other metabolic stresses.
Microwaves have been know to cause formula to explode glass bottles, and over heated formula has caused burns to babies mouths and throats (S M Murphy et al, BMJ).
Intake controlFormula fed babies cannot control their caloric intake the way that breastfed infants can. The suck cycle ensures that thirsts quenching milk comes first with caloric milk after for the hungry, not just thirsty infant.
Babies control breastfeeding. Mothers control formula-feeding.
Immunological factorsBreastmilk contains white cells (macrophages and lymphocytes), anti-inflammatory components and non antibody factors as discussed above.
Five types of immunoglobulin have been identified in breast milk – A,D,E,G and M (mainly IgA).
The mothers body is also able to monitor and respond to potential pathogens in her infant’s environment via a sophisticated system known as the broncho mammary and entero-mammary circulation. Pathogens entering the mothers system stimulate the lymphocytes on the bronchial mucosa and the Peyer’s patches on the small intestine. Activated B cells migrate via the blood to the mammary glands, and send antibody to the milk. Genius. (Newman 1995).
Other factors:Also present in colostrum and human milk:
Amylase, BSSL, lipoprotein lipase, epidermal growth factor, human growth factor, nerve growth factor, cytokines, prostaglandin, interferon, tumour necrosis factor (TNF), alpha -1 antitrypsin. Hormones such as thyroxine, adrenal and ovarian steroids, calcitonin, oxytocin, prolactin, erythropoietin. None of these are found in formula. (Aynsley-Green 1983)
Financial factors:For every 1% increase in breastfeeding, the average health authority would save 6000 euro in reduced hospital admissions for gastroenteritis!
A 10% increase would thus save 60,000 euro.
The same increases in breastfeeding would save 13,000 Euro for 2 cases of Diabetes averted and 25,000 euro for 4 cases of NEC.
HSE, listen up!
We need to spend money on those least likely to breastfeed – the young, the poor and those with the least education. However, government spending on breastfeeding is not likely to match the vast quantities of money being spent on seeing breastfeeding fail – the formula companies.
Our bottle feeding society will turn back into a breastfeeding one only when we as a nation realise that it is in EVERYONE’s interest that children are breastfed.
References:The infant formula controversy:
Aynsley-green. Hormones and postnatal adaptation to enteral nutrition.
J Pediatr Gastroenterol Nutr. 1983;2(3):418-27. Review. No abstract available.
Walker M. A fresh look at the risks of artificial infant feeding.
J Hum Lact. 1993 Jun;9(2):97-107.
S M Murphy, DJA Orr
Burns caused by steam inhalation for respiratory tract infections in children.
BMJ. 2004 Mar 27;328(7442):757. No abstract available.
Bovine serum albumin detected in infant formula is a possible trigger for insulin-dependent diabetes mellitus.
J Am Diet Assoc. 1994 Mar;94(3):314-6. No abstract available.
Jooste et al. Effect of breast feeding on the plasma cholesterol and growth of infants.
J Pediatr Gastroenterol Nutr. 1991 Aug;13(2):139-42.
Specker et al. Low serum calcium and high parathyroid hormone levels in neonates fed 'humanized' cow's milk-based formula.
Am J Dis Child. 1991 Aug;145(8):941-5.
PDFs:The Biological Specificity of breastmilk
Books:Infant feeding: the physiological basis. Akre, J
For more information and tables regarding breastmilk constitution and comparison to formula see “Successful Breastfeeding, RCM” - Amazon link
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Breastfeeding –the natural choice 
