Women’s Health Risks Associated With Orthodox Medicine – Part II
Breastfeeding Versus Formula Feeding
Nearly 20 studies conducted since the late 1980s have identified negative effects of formula feeding or positive effects of breast-feeding. In this body of research, breastfeeding emerges as a clear winner over formula feeding.
The World Health Organization helps protect breast-feeding with a code that regulates the marketing of milk substitutes. As reported in the British Medical Journal, however, widespread violations of the code have been reported by several health agencies. The author notes that the resulting use of commercial preparations is associated with much harm. Bottlefed babies have significantly higher rates of childhood diseases and impaired cognitive development; they also have a higher risk of cardiovascular diseases as adults.12
Many of the studies that follow bear out this potential for harm. The research shows that bottle-fed babies have an increased risk of neurological dysfunction, diarrhea, middle ear infections, and respiratory infections, as well as allergic disorders, cardiovascular disease, and diabetes later in life.13-20
On a positive note, other studies show that breast-fed infants not only have lower rates of infection and gastrointestinal illnesses21-22 but also demonstrate higher (and long-lasting) levels of cognitive development. A recent study in Pediatrics states that children who were breast-fed as infants had significantly higher IQs and scholastic performances at every point they were tested—from first grade through high school.23
The results of this study show that women who receive informational material publicizing infant formulas at their first prenatal visit are almost 6 times as likely to interrupt breastfeeding before leaving the hospital, compared to women who receive research material promoting the benefits of breast-feeding. Women exposed to company-produced advertisement material are also almost twice as likely to cease breastfeeding before 2 weeks compared to those who receive research material. Babies who are breast-fed have improved health outcomes such as lower rates of infections, allergies and chronic diseases, compared to formula-fed babies. The authors emphasize that information material produced by formula manufacturers should not appear in doctors’ offices, prenatal clinics and hospitals, especially considering that the World Health Organization’s code regulating marketing of milk formulas “prohibits the distribution of free samples, the promotion of formula in health care facilities, and the use of pictures idealizing artificial feeding.”
—Howard C, Howard F, Lawrence R, Andresen E, DeBlieck E, Weitzman M, Office prenatal formula advertising and its effect on breast-feeding patterns. Obstet Gynecol 2000 Feb; 95(2):296-303.
The results of this study show that women who, upon delivery, received a hospital discharge package containing a manual breast pump, continued to breast-feed their baby significantly longer (4.2 weeks) than women who received a hospital discharge package containing an infant formula (2.8 weeks). Furthermore, women who felt that relief from nighttime feeding was important, were significantly more likely to breast-feed for more than 8 weeks if they received in the package the manual breast pump instead of the infant formula.
—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.
This study documented the extent of violation of the World Health Organization’s code regulating the marketing of milk substitutes worldwide. Marketing efforts of milk substitutes’ manufacturers have altered the perception of breast-feeding in women, and distribution of free samples of milk formulas and of advertisement material has resulted in a significant number of women opting for using commercial preparations rather than breast-feeding. This practice, however, is associated with significant harm, in that babies who have been bottle-fed have significantly higher rates of childhood diseases, impaired cognitive development, and higher risk of cardiovascular diseases in adulthood. The most devastating consequences of bottle-feeding occur in the developing countries, where neonates and infants are particularly at risk of contracting infectious diseases from contaminated water added to the formula. As reported in an editorial published in the same issue of the BMJ (BMJ 1998;316:1103-1104), the World Health Organization estimated that 1.5 million deaths could be prevented every year if women would breast-feed rather than bottle-feed their babies. To ensure protection of breast-feeding the WHO developed a regulative code that prohibits the distribution of free samples of milk formulas to women or health facilities (except for professional research).
In addition, the code forbids the provision of incentives to health care workers, which has been associated with an increased likelihood of promotion of a particular product and with the lack of support of breast-feeding. The article highlights how several agencies have reported widespread violations of the code, but the companies have consistently rejected any allegation as unreliable and distorted by activists. This study monitored compliance to the WHO code by conducting a systematic, random survey of women and health care professionals in one city in each of Bangladesh, Poland, South Africa, and Thailand. Women were asked if they had been given free samples of milk substitutes, bottles and teats, while they were pregnant or in the six months after delivery. In addition, three health care workers in each facility were interviewed to assess whether the facility had received free samples of milk substitutes or gifts from companies involved in their production or distribution. The results of the survey showed that overall, 10% of all women (range 0-26%) and 25% of all health care facilities (range 8-50%) interviewed had been given free samples of milk, bottle, or teats for research purpose. Thirty percent of health facilities had received violating information and 11% of health care professionals had received gifts. These findings, which are likely underestimating the real dimension of the problem in the majority of the countries, point to the extent of violation of the WHO code by breast milk substitutes’ manufacturers. The consequences of these violations in terms of increased mortality and loss of health are staggering.
—Taylor A, Violations of the international code of marketing of breast milk substitutes: prevalence in four countries. BMJ 1998; 316:1117-1122 (11 April).
This article reports on the findings of an external audit demonstrating multiple violations of the World Health Organization’s code of marketing of breast milk substitutes in Pakistan perpetrated by Nestlé. The discovery came after a former Nestlé employee exposed internal documents demonstrating that the company offered gifts to doctors as a recompense for promoting its products. In addition, the company was charged with offering free infant formulas to mothers and health care professionals, practices that are forbidden under the code’s requirements.
—Yamey G, Nestlé violates international marketing code, says audit. News. BMJ 2000; 321:8 (1 July).
The results of this study show that bottle-fed infants have a 50% increased risk of neurological dysfunction, compared to breast-fed infants. The authors propose that the presence of longer-chain polyunsaturated fatty acids, found in breast milk but not in most formula-milks, may be a factor involved in the excess risk, since these fatty acids play a vital role in brain development.
—Lanting CI, Fidler V, Huisman M, Touwen BC, Boersma ER, Neurological differences between 9-year-old children fed breast-milk or formula-milk as babies. Lancet 1994 Nov 12; 344(8933):1319-22.
The results of this meta-analysis, conducted on 20 previously published studies, show that breast-fed infants have significantly higher levels of cognitive development, compared to formula-fed infants. The differences were observed at 6-23 months and remained thereafter. The longer the duration of breast-feeding, the stronger the benefits observed on cognitive development. Premature children were found to benefit the most from breast-feeding.
—Anderson JW, Johnstone BM, Remley DT, Breast-feeding and cognitive development: a meta-analysis. Am J Clin Nutr 1999 Oct; 70(4):525-35.
This study evaluated cognitive development in children aged 2 through 5 fed by different modes when infants. Breast-fed children were found to score significantly higher in developmental tests at all time points, compared to bottle-fed children.
—Rogan WJ, Gladen BC, Breast-feeding and cognitive development. Early Hum Dev 1993 Jan; 31(3):181-93.
The results of this study show that the improved performances in cognitive tests observed in breast- versus bottle- fed children early in life are maintained throughout childhood and young adulthood. Children who had been breast-fed as infants had significantly higher intelligence quotients and scholastic performances at all points tested, from first grade through high school. The longer the children were breast-fed, the better their cognitive development and academic performances into early adulthood.
—Horwood LJ, Fergusson DM, Breastfeeding and later cognitive and academic outcomes. Pediatrics 1998 Jan; 101(1):E9.
The results of this study show that infants aged 0 to 3 months who are breast-fed have significantly lower rates of infections and hospitalization compared to children who are bottle-fed.
—Fallot ME, Boyd JL 3d, Oski FA, Breast-feeding reduces incidence of hospital admissions for infection in infants. Pediatrics 1980 Jun; 65(6):1121-4.
The results of this study show that infants who have been breast-fed for at least 13 weeks have significantly lower rates of gastrointestinal illnesses and hospitalizations during the first year of their life, compared to those who have been bottle-fed from birth. Breast-feeding for less than 13 weeks is not associated with reduction of gastrointestinal disease.
—Howie PW, Forsyth JS, Ogston SA, Clark A, Florey CD, Protective effect of breast feeding against infection. BMJ 1990 Jan 6; 300(6716):11-6.
The results of this study, conducted on 153 Peruvian newborns, show that during the first 6 months of their life infants who received other liquids in addition to breast milk had a 2-fold increased incidence of diarrheal disease, compared to those who received exclusively breast-milk. The incidence of diarrheal disease in infants in whom breast-feeding was discontinued during their first 6 months of life was 4 times higher than that of exclusively breast-fed infants. Rates of upper and lower respiratory infections and of skin infections were also lower in exclusively versus partially breast-fed infants.
—Brown KH, Black RE, Lopez de Romana G, Creed de Kanashiro H, Infant-feeding practices and their relationship with diarrheal and other diseases in Huascar (Lima), Peru. Pediatrics 1989 Jan; 83(1):31-40.
The results of this study show that children who have been exclusively bottle-fed have an 80% increased risk of developing diarrhea and a 70% increased risk of developing middle ear infections, compared to those who have been exclusively breast-fed.
—Scariati PD, Grummer-Strawn LM, Fein SB, A longitudinal analysis of infant morbidity and the extent of breastfeeding in the United States. Pediatrics 1997 Jun; 99(6):E5.
The results of this study, conducted on 1,058 Chinese infants, show that those who were exclusively bottle-fed were twice as likely to be hospitalized for respiratory infections during their first 18 months of life, compared to those who were partially or exclusively breast fed.
—Chen Y, Yu SZ, Li WX, Artificial feeding and hospitalization in the first 18 months of life. Pediatrics 1988 Jan; 81(1):58-62.
The results of this study, conducted on 152 infants aged 1 month to 1 year admitted to a Brazilian hospital for pneumonia and 2,391 matched controls, show that those who have been exclusively bottle-fed had an overall 17-fold increased risk of being hospitalized for this complication, compared to those who have been exclusively breast-fed. The risk was particularly high for children younger than 3 months, for whom bottle-feeding was associated with a 61-fold increased risk of pneumonia, and decreased down to 10 for older children. Strikingly, the study also found that the addition of solid foods to the diet of infants younger than 3 months of age was associated with a 175-folds increased risk of hospitalization for pneumonia, down to a 13- folds increase in children of all ages.
—Cesar JA, Victora CG, Barros FC, Santos IS, Flores JA, Impact of breast feeding on admission for pneumonia during postneonatal period in Brazil: nested case-control study. BMJ 1999 May 15; 318(7194):1316-20.
The results of this study show that children who have been partially or exclusively bottle-fed during the first 15 weeks of life have an almost 2-fold higher risk of developing respiratory illness later in childhood, compared to those who have been exclusively breast-fed. Exclusive bottle-feeding was also associated with significantly higher levels of blood pressure later in childhood, compared to breastfeeding. In addition, the introduction of solid foods to the diet of infants younger than 15 weeks was found to be associated with an over 2-fold higher risk of wheeze during childhood, and with significantly increased percentage body weight and fat.
—Wilson AC, Forsyth JS, Greene SA, Irvine L, Hau C, Howie PW, Relation of infant diet to childhood health: seven year follow up of cohort of children in Dundee infant feeding study. BMJ 1998 Jan 3; 316(7124):21-5.
The results of this study show that the introduction of milk formulas to the diet of infants younger than 4 months is associated with a significantly higher risk of developing asthma and allergic disorders later in life. In particular, children who had been fed non-breast milk before 4 months of age were found to have a 25% higher risk of developing asthma and a 30% higher risk of having a positive skin prick test, compared to those who had been exclusively breast-fed.
—Oddy WH, Holt PG, Sly PD, Read AW, Landau LI, Stanley FJ, Kendall GE, Burton PR, Association between breast feeding and asthma in 6 year old children: findings of a prospective birth cohort study. BMJ 1999 Sep 25; 319(7213):815-9.
The results of this study show that individuals who have been bottle-fed when they were babies have more risk factors for cardiovascular disease and diabetes later in adulthood, compared to those who have been breast-fed. The study was conducted on 625 adults born in Amsterdam between 1943 and 1947. Those who had been bottle-fed had higher plasma glucose concentration after a glucose load test and higher cholesterol levels, compared to those who had been breast-fed. These data support previous research indicating an increased risk of cardiovascular diseases associated with bottle-feeding.
—Ravelli AC, van der Meulen JH, Osmond C, Barker DJ, Bleker OP, Infant feeding and adult glucose tolerance, lipid profile, blood pressure, and obesity. Arch Dis Child 2000 Mar; 82(3):248-52.
The results of this study show that children who have received cow’s milk-containing formulas when they were younger than 3 months have a 52% increased risk of developing insulin-dependent diabetes mellitus (IDDM or Type 1 diabetes), compared to those who have been exclusively breast-fed. Duration of exclusive breast-feeding for 3 months or longer was found to be associated with a 44% reduced risk of Type 1 diabetes.
—Verge CF, Howard NJ, Irwig L, Simpson JM, Mackerras D, Silink M, Environmental factors in childhood IDDM. A population-based, case-control study. Diabetes Care 1994 Dec; 17(12):1381-9.
The results of this study show that the introduction of supplementary infant formulas into the diet of infants younger than 3 months is associated with a 52% higher risk of developing Type 1 diabetes later in life. Exclusive breast-feeding during the first 2 months of life, on the other hand, is protective, and is associated with a 40% lower risk of developing diabetes.
—Virtanen SM, Rasanen L, Aro A, Ylonen K, Lounamaa R, Tuomilehto J, Akerblom HK, Feeding in infancy and the risk of type 1 diabetes mellitus in Finnish children. The ‘Childhood Diabetes in Finland’ Study Group. Diabet Med 1992 Nov; 9(9):815-9.
The results of this study show that the introduction of supplementary milk feeding to the diet of infants younger than 3 months is associated with a 53% higher risk of developing Type 1 diabetes, compared to the introduction of milk formulas after the age of 3 months.
—Hypponen E, Kenward MG, Virtanen SM, Piitulainen A, Virta-Autio P, et al., Infant feeding, early weight gain, and risk of type 1 diabetes. Childhood Diabetes in Finland (DiMe) Study Group. Diabetes Care 1999 Dec; 22(12):1961-5.
