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I have kept my mouth shut about this…til now. But this is really the outside of enough, folks. I mean, come ON!

Study: Lack of breastfeeding costs lives, billions of dollars

(CNN) — If most new moms would breastfeed their babies for the first six months of life, it would save nearly 1,000 lives and billions of dollars each year,

Let me note now that I breastfed both my children til each one was a year old and breastfed exclusively through the first four months, so my absolute disgust with this article is in no way some kinda guilt-fueled defensive huffiness. I was a good little Mommie! I saved nearly 1,000 lives and billions of dollars each year! (I could use some of that money right now too, thanks–drop me an email, whoever is holding onto that?)

Dr. Melissa Bartick, one of the new study’s co-authors, says the vast majority of extra costs incurred each year could be saved “if 80 to 90 percent of women exclusively breastfed for as little as four months and if 90 percent of women would breastfeed some times until six months.”

Bartick and her co-author Arnold Reinhold found that most of the excess costs are due to premature deaths.

Oh good. Let’s examine these babies, heartlessly slaughtered by their mothers’ psychotic refusal to breastfeed! I mean, who knew…

Nearly all, 95 percent of these deaths, are attributed to three causes: sudden infant death syndrome (SIDS); necrotizing enterocolitis, seen primarily in preterm babies and in which the lining of the intestinal wall dies; and lower respiratory infections such as pneumonia.

Breastfeeding has been shown to reduce the risk of all of these

So, basically what we have here is:

1. Breastfeeding reduces the risk of SIDS.
2. Breastfeeding reduces the risk of either having a preterm baby or of that preterm baby dying of necrotizing enterocolitis.
3. Breastfeeding reduces the risk of a baby either catching a lower respiratory infection or of dying of a lower respiratory infection.

I like no. 1, because SIDS is defined as a syndrome marked by the sudden death of an infant that is unexpected by history and remains unexplained after a thorough forensic autopsy and a detailed death scene investigation. In other words, SIDS isn’t actually a cause of death–it’s a lack of knowledge of the cause of death even after an autopsy and death scene investigation. Back to SIDS:

Risk factors that are not causes of SIDS

The cause of SIDS is unknown. Any proposed causation factor must be either necessary and sufficient to cause SIDS by itself (as the rabies virus causes rabies) or necessary and insufficient to cause SIDS by itself (as the typhus bacillus may or may not cause typhoid, a la ‘Typhoid Mary’).

Although studies have identified risk factors for SIDS, such as putting infants to bed on their stomachs, there has been little understanding of the syndrome’s biological cause or potential causes. The frequency of SIDS appears to be a strong function of the infant’s sex, age and ethnicity, and the education and socio-economic-status of the infant’s parents.

Listed below are several risk factors associated with increased probability of the syndrome based on information available prior to this recent study.

Prenatal risks

* maternal nicotine use (tobacco or nicotine patch)
* inadequate prenatal care
* inadequate prenatal nutrition
* use of heroin, cocaine and other drugs
* subsequent births less than one year apart
* alcohol use
* infant being overweight
* mother being overweight
* Teen pregnancy (if the baby has a teen mother, it has a greater risk)
* infant’s sex (60% of SIDS cases occur in males)

Post-natal risks

* mold
* low birth weight
* exposure to tobacco smoke
* prone sleep position
* not breastfeeding
* elevated or reduced room temperature
* excess bedding, clothing, soft sleep surface and stuffed animals
* Co-sleeping with parents or other siblings may increase risk for SIDS, but the mechanism remains unclear
* infant’s age (incidence rises from zero at birth, is highest from two to four months, and declines towards zero at one year)
* premature birth (increases risk of SIDS death by about 4 times. In 1995-1998 the U.S. SIDS rate for 37–39 weeks of gestation was 0.73/1000; The SIDS rate for 28–31 weeks of gestation was 2.39/1000)
* anemia

Well, NOT BREASTFEEDING is in there…along with twenty other risk factors. But why let that stop us from making massive, sweeping general statements about the hordes of babies dying from SIDS caused by lack of breastfeeding?

On to no. 2…I really don’t think we can make a case that breastfeeding has much to do with whether or not your baby is premature, given that breastfeeding can’t start prior to birth, so I’m assuming that the study authors are saying that the preterm baby specifically dying of necrotizing enterocolitis is caused by a lack of breastfeeding. So let’s look at that.

Necrotizing enterocolitis (NEC) is a medical condition primarily seen in premature infants, where portions of the bowel undergo necrosis (tissue death).

NEC has no definitive known cause.[3] An infectious agent has been suspected, as cluster outbreaks in neonatal intensive care units (NICUs) have been seen, but no common organism has been identified.

Not breasfeeding probably swept through those particular NICU wards, like a fever of anti-sisterhood!

Pseudomonas aeruginosa is suspected for causing necrotising enterocolitis in premature infants and neutropaenic cancer patients,[often secondary to gut colonisation. A combination of intestinal flora, inherent weakness in the neonatal immune system, empirical antibiotic use for 5 days or more,alterations in mesenteric blood flow and milk feeding may be factors.

Ooh, there it is!

NEC is almost never seen in infants before oral feedings are initiated.

Lest we lose our comprehension entirely of the situation in our eagerness to obsess on breastfeeding as akin to the Ten Commandments, reread that sentence. In other words, the primary risk factor, hands down, for necrotizing enterocolitis, is being born before your digestive system has finished maturing. Period. Your mother’s tits or lack thereof were not even involved. Rinse, repeat–

But, to be fair:

Formula feeding increases the risk of NEC by tenfold compared to infants who are fed breastmilk alone.

For more clarity as to why this is:

Neonatologists at the University of Iowa NICU reported on the importance of providing small amounts of trophic oral feeds of human milk starting ASAP, while the infant is being primarily fed intravenously, in order to prime the immature gut to mature and become ready to receive greater oral intake (Ziegler and Carlson, J Matern Fetal Neonatal Med. 2009 Mar;22(3):191-7.) Human milk from a milk bank or donor can be used if mother’s milk is unavailable.

This is a medical treatment, not a lifestyle choice. This has absolutely zero to do with whether or not you started supplementing Junior’s breastmilk diet with pureed pear when he was three months old, nor even if the second you got Janey out of the hospital and home you popped a bottle of Similac into her little mouth. Neither baby is at any risk anymore of necrotizing enterocolitis

Moving on to no. 3, a quick review of the medical literature out there will quickly inform you that, by far, the greatest risk factor for both catching and dying of a lower respiratory tract infection as a baby is…you guessed it…being born prematurely. Which, as we’ve already demonstrated, doesn’t have shit to do with breastfeeding as it’s hard to wiggle a nipple up your cervix while gestating and even if you are a circus-grade contortionist and can manage it, you’re not producing milk and your fetus wants and needs said milk about as much as it wants and needs a cellphone or new car. Let me repeat: neonatal mortality (occurring within 28 days of birth) accounts for the great majority of baby deaths, and the leading cause of neonatal death is prematurity. So, basically, the deaths we are talking about preventing with breastfeeding are postneonatal (between 28 days after birth and one year).

I couldn’t find a US study concentrating specifically on postneonatals, breastfeeding and lower respiratory infection, but I did find a UK study, and their breastfeeding statistics seem similar to ours, so here are the numbers:

Seventy percent of infants were breastfed (ever), 34% received breast milk for at least 4 months, and 1.2% were exclusively breastfed for at least 6 months. By 8 months of age, 3.2% of infants had been hospitalized for lower respiratory tract infection.

Wow. 98.8% of the babies weren’t exclusively breastfed and 66% of them didn’t even get breast milk for at least 4 months! And…96.8% of them did not catch a lower respiratory tract infection.

Population-attributable fractions suggest that an estimated 27% of lower respiratory tract infection hospitalizations could have been prevented each month by exclusive breastfeeding and 25% by partial breastfeeding.

So, put another way–breastfeeding wouldn’t have prevented about three-quarters of the lower respiratory tract infections from occurring at all.

FEARMONGERING AND WOMAN-BLAMING–MY FAVORITES!

In conclusion, I would like to point out that indeed, there are some benefits to the health of your child if you choose to breastfeed some or all of the time. However, if you don’t, you are not costing society billions of dollars nor are you causing any babies, including your own, to die of anything at all. And everyone who says you are is full of shit. End message!

This entry was posted on Monday, April 5th, 2010 at 1:24 pm and is filed under Punkass!, "Science", Brilliant Ideas, For the ladies, Lick My Jackboots of Love, What Patriarchy?, What would we do without such great advice?. You can follow any responses to this entry through the RSS 2.0 feed. You can leave a response, or trackback from your own site.