Any major field of pseudoscience worth its salt creates an alternative world of internal legitimacy. It doesn’t matter whether it is deadly antivaxx activism, naturopathy, or natural childbirth. They all do it to hide the fact that mainstream science and medicine look upon them as ignorant fools.
What’s an alternate world of internal legitimacy?
[They]have built an alternative world of internal legitimacy that mimics all the features of the mainstream research world — the journals, the conferences, the publications, the letters after the names — and some leaders have gained access to policy-making positions. Mixing an environmentally inflected critique of [obstetrics] and Big Pharma with a libertarian individualist account of health has been a resonant formulation for some years now, with support flowing in from both the Left and the Right.
This is a description of vaccine rejectionists, paraphrased from the paper The Legitimacy of Vaccine Critics: What Is Left after the Autism Hypothesis? by Anna Kirkland, published in Journal of Health Politics, Policy and Law in October 2011. It applies equally well to natural childbirth and homebirth advocates.
The latest addition to the alternate world of natural childbirth advocacy is the film Microbirth, conceived, produced, and funded by natural childbirth advocates desperate to demonize C-sections. Its thesis?
…We believe “seeding of the baby’s microbiome” should be on every birth plan – for even if vaginal birth isn’t possible, immediate skin-to-skin contact and breastfeeding can still help to provide bacteria crucial to the development of the baby’s immune system. In the scientists’ view, if we can get the seeding of the baby’s microbiome right at birth, this could make a massive difference to the baby’s health for the rest of its life. Consequently, we believe that “Microbirth” is of extreme importance for global health and potentially, for the future of mankind!
Let’s leave aside the breathless hyperbole for the moment and ask some simple questions. Who do is the “we” when the producers of Microbirth announce “we believe”? It’s not microbiologists since there is NO scientific consensus on the composition of the neonatal microbiome, let alone what it ought to be. Microbiologists do not yet understand how much of the tremendous variation from individual to individual reflects anything other than the fact that individuals differ in a myriad number of ways. Microbiologists do not yet understand the short term impact of the neonatal microbiome, let alone the long term impact. Microbiologists do not yet understand how the micro-virome (the viruses that normally live inside human beings) impacts the microbiome.
It’s not neonatalogists and pediatricians since they aren’t going to “believe” anything about the microbiome that isn’t established by microbiologists. That goes for obstetricians, too. So the ONLY people who “believe” that the neonatal microbiome is crucial to the development of the health and future wellbeing of infants … the only people who believe that vaginal birth is necessary to create the proper neonatal microbiome … the only people who “believe” that C-section deprives babies of the necessary microbiome are ideologues committed to unmedicated vaginal birth and strongly opposed to C-sections.
The movie Microbirth, therefore, is yet another attempt to bolster the alternative world of internal legitimacy that characterizes NCB advocacy. It was produced by, about, and for natural childbirth advocates, and is designed to convince the gullible who are ignorant of basic microbiology and desperate to demonize C-sections.
My questions for the midwives, doulas and natural childbirth advocates waxing rhapsodic about Microbirth are these:
1. How can you be so oblivious as to fail to notice that the only people promoting Microbirth are people with no expertise in microbiology?
2. Are you so ignorant and naive that you would actually believe a movie about microbiology made by people who have no expert knowledge of microbiology?
3. Why are you foolish enough to imagine that natural childbirth advocates either know or care more about the wellbeing of infants than neonatologists and pediatricians?
4. Can’t you see that you are being manipulated?
5. Or are you just so desperate to believe that you simply don’t care?
Inquiring minds want to know.
Okay, well where might one find reliable information about this, or are you just saying that so far there isn’t any? When would the bacteria be acquired by a newborn? Before birth, after, during? A combination of all those? I remember reading that it was generally during/after, not before, and so I asked my OB about the effect that antibiotics might have on that population when a Group B strep test came back positive for me while pregnant with our fourth baby (they had been negative with the other three, so it was a new thing for us). He said he had never gotten a question like this and didn’t know, nor did he know where one might find answers. This pregnancy, our fifth baby, I am being seen prenatally at a birth center (I am not a natural birth advocate necessarily, though that has been what I’ve been fortunate to have for three of four babies, one having been induced at forty-two full weeks/the beginning of the forty-third week, and what I’d prefer in the future.) ANYWAY, the midwife I happened to see yesterday for a routine appointment highly recommended Microbirth as a definitive answer to this question when the question of being tested for Group B strep in a few weeks came up. Documentaries can obviously be spun any way the creators want, so ideally I’d like concrete information one way or the other. I’m certainly not asking you to decide yes/no on the test or yes/no on the antibiotics (I did indeed get a dose of them for the pregnancy in which I tested positive, though there wasn’t time for a second dose), what I’m asking for, if you have it/access to it/resources, is where I might find reliable information, as you say that Microbirth is not that. The OB didn’t know, the midwife claims to but might not, where does a normal pregnant person without medical credentials and access and such find answers to this if not with the professionals?
I know that I’m posting FOREVER after you wrote this, but can’t hurt to ask, no?
Dr. Amy and ScienceBasedMedicine have both discussed this periodically. i got the impression that the science on it is still too new to draw much of a conclusion, at least how it applies to babies.
Yes, I’ve seen it broached/vaguely discussed/mentioned as part of something else, sort of like in this post (where the original post wasn’t specifically to do with antibiotics so much as the microbiome, etc.) but nothing specific. Eh well. I suppose sticking with the science of antibiotics and heavy supplementation with probiotics might give the best of both approaches.. Hopefully it’ll be a non-issue and this pregnancy the swab’ll be negative ;]
With #1, i had strep and antibiotics, but didn’t bother with probiotics. He’s had the normal amounts of colds and no problem with eating anything i let him get his hands on. #2 is imminent, and I don’t have strep with her, though of course i can’t gaurantee her method of entrance, but we’re anticpating vaginal like her brother.
Well, anecdotal evidence is easy to come by, mine is the opposite. The first three had no antibiotics and had no stomach issues, the fourth got antibiotics at birth through me and had colic-like problems only remedied by probiotics and time. What I was (am) looking for was (is) whether it’s true that their guts are colonized at birth, whether antibiotics affect that colonization, or any other, negatively, and how one might counteract the negative influence is there is one. I’m guessing though that the only science available is the kind that is semi suspect.. Which isn’t evidence either of course.
So who is more deeply in the imaginary world? With confirmation bias so prevalent in the name of protecting we lay people from quackery we are being done a disservice. Reviewing the infant mortality rate of the US when compared to not just the rest of the western world but finding it below some third world countries, and notwithstanding the increasing incidence of obesity, cancer, diabetes and autism spectrum disorders, US health outcomes and costs are worse than embarrassing. It’s no wonder thoughtful people and many healthcare professionals have become disillusioned with what has become of our medical/pharmaceutical system and are seeking to fill the void.
Wake up. Ask questions. Demand honest, thoughtful answers. Be skeptical without being dismissive. Your children and their children’s lives and quality of life depend on it.
Which third world countries are those?
Infant mortality in the USA is not due to failures of the medical system, but to unequal access to it.
I have demanded answers. You ask questions that sound provocative only to the ignorant.
Pro tip: When hoping to be taken seriously in a discussion of obstetric practice, use the correct statistic. Infant mortality (death from birth to one year) is a measure of PEDIATRIC care. According to the World Health Organization, the best measure of obstetric care is PERINATAL mortality. According to the WHO, the US has one of the lowest perinatal mortality rates in the world.
Of course, you didn’t know that because all you read about on NCB sites was infant mortality. They figured you were too uneducated to tell the difference, and they were right!
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Why is it the “skeptical” nature of this site not so skeptical. Instead, things are so very black and white. We as parents, consumers, scientists and healthcare provides do not truly know all of the benefits and risks of breast or bottle feeding. Preliminary, and with good evidence we know that breast milk is better for babies. We know that formula is a synthetic substitute for human milk. Why are breastfeefing advocates demonized for promoting what appears to be the healthiest choice…Microbiome or not.
Further dichotomous thinking of this blog…results are important, but so is the process. One does not necessarily negate the other. Certainly the outcome trumps the process. Why must hate and disdain be directed at those that support natural processes? Birth is just that, so is breastfeefing. In most cases, both can occur without much intervention. Recent medical advances have allowed for interventions to occur. No doubt C/S and formula feeding have saved many mothers and their babies. However, these should not be considered the norm. I do not understand the purpose of this blog. It selects only some evidence that supports it’s opinion. There is no objectivity or reasonable debate here.
Only “demonized” for lying about breastfeeding. And for sounding off about things you just don’t understand at all.
The current best evidence shows that breast milk has only marginal benefits over formula, if any.
As for demonizing breastfeeding advocates, yes, I don’t like them. Why? Because they have lead to an overzealous approach to breastfeeding that shames mothers who cannot meet the ideal as set by them. This approach has led to nurses walking into a postpartum room, grabbing women’s breasts without permission, and shoving baby on the boob. It has lead to a breast cancer survivor being told she should try to produce milk, despite her radical double mastectomy. It has lead to asking women to sign “contracts” while still in hospital, stating that breast milk was by far the best food for their child and they would commit to exclusive breast feeding.
Refusal of the lactivist community to place a mother’s mental health at least equal to her baby’s health has exacerbated countless episodes of post-partum depression. It has lead to parents feeling shamed for feeding their children something “lesser.”
It has to stop. Women who want to breastfeed should be provided with as much support as they want or need to achieve their goals. But women who feed formula are not bad mothers and people need to stop treating them like they’re poisoning their babies.
All the things you mentioned are horrible and not acceptable to anyone in civilized society. But most women who CAN breastfeed and CHOOSE not to think formula is benign. Same goes to women whose infants are routinely given formula in hospital without second thought. This may in fact have risk (hence why I am posting one last post on the topic as it pertains to gut flora), and women need to know this. Medical exceptions/supply issues where formula is truly “required” are noted.
But the simple fact is, women need to be informed women who make informed choices. Regardless of if the data subjectively fits their opinion.
For those women who MUST use formula, again, I state that these women should demand better, and that better hopefully can be achieved. But they fight amongst themselves in a form of lateral violence instead of working towards a goal.
Now thankfully, this will be the last post on this subset of the topic for me.
Please show that formula is harmful.
Yes, we do believe that formula is benign… because the best available evidence indicates that it is. Women need to know that. Failing to tell them is leaving them uninformed. Saying otherwise is misinformation.
Breast milk may be a little bit better, but small differences in quality aren’t the only basis for feeding decisions.
“Demand better”
Better than what? A cheap, readily accessible, easily prepared product that saved my baby’s life?
I can’t think of much better than that.
Not only that, but the empty packages make awesome blocks for him to play with.
Also the perfect size container for a car kit (fits a couple diapers, wipes, spare change, baby food pouches and a onesie if you roll everything up well)
I’m glad you make sure your baby has spare change; so many changing facilities don’t take AmEx these days…
Comes in handy for those diaper dispensers at IKEA : )
Great idea!
I bet you think it’s benign too, don’t you?! Deluded wretch. 😉
Some mothers also CHOOSE not to think vaccines are benign. Since when does a mother’s choices have an impact whether or not something is harmful?
I am a huge believer in the benefits of breastfeeding. No one on this blog has criticized or “demonized” me for that. I draw the line at telling my friends, family and others how to feed their babies. I know and have personally experienced the pros and cons. I plan to breastfeed again and hopefully exclusively. If for some reason I can’t that’s okay too because I know there are great alternatives.
You want to know something? I love this blog, because it talks about the importance of healthy babies and not judging mothers for making decisions outside the realm of “natural” mothering. I don’t know what you mean by the norm. To me the norm should always be healthy mothers and healthy babies, whatever that means for each family.
“Objectivity” and “reasonable debate”
I suspect these words do not mean what you think they mean. This blog is precisely about objectivity and reasonable debate. Sometimes it is difficult or confronting to have our unconscious assumptions brought out into the light and stacked up against the evidence – so many of our value judgments are intuitive. But that doesn’t make them factually correct or objective. And that doesn’t make challenges to them ‘unreasonable’.
Please truly think about this question – why shouldn’t c-sections and formula feeding be the norm? Use evidence, not personal feelings.
And be prepared for your evidence to be critiqued. Because that’s what debate is.
You’re absolutely right that outcome trumps process. My healthy baby trumped whether or not she came out of my vagina. My healthy baby trumped continuing with exclusive breastfeeding when she was wasting away.
If you have counter “evidence” please provide it for us skeptics. You want us to consider all sides? Provide the other side.
So you don’t understand the purpose of this blog. Then shew. Skiddable. Stay in your imaginary world, and we on the front lines will continue to fist-pump Dr. Amy’s posts and then share our own stories here. I don’t understand MANY things, and I tend to stay away from blogs that support those things….it makes my life easier. So, buh-bye.
You, who are on the front lines…,propagating bad information? Do you know the “evidence” that negates the value of breastfeeding to which Dr. Amy refers? It is the Colen study that was published a few months ago. It’s seems rather extensive….nearly 60 pages. Problem is 1.) it is ONE study 2.) Participants did not indicate the length of time breastfeeding occurred or whether it was exclusive.
I will say again, the purpose of this blog is for people who want to share anecdotal knowledge and support their biases with ‘evidence’ that lacks value or authenticity.
Breastfeeding is the best option. Not all women can. Fine. To blow out of proportion the misfortune of a cancer survivor’s story in order to promote one’s own anti-lactation cause is foolishness. Far more often is the new mom who wants to breastfeed. She tries unsuccessfully and gets handed a bottle as soon as she reaches the postpartum floor…especial post-op and on night shift.
One descent study: Bellfield and Kelly (2010)
In addition, do we ignore recommendations of APA here? Let’s remember they are the experts on infant health, not OB/GYNs.
The American Psychologic Association?
I think you mean the AAP.
On the front lines…being a NICU nurse. So, yeah.
Also…have you ever been to a baby friendly hospital? They most certainly do not hand you a bottle of formula when you walk into postpartum. They lock that stuff up now.
“Far more often is the new mom who wants to breastfeed. She tries unsuccessfully and gets handed a bottle as soon as she reaches the postpartum floor…especial post-op and on night shift.”
Well if you go for anecdotes I was a mess and sent my husband to beg and plead to get a bottle for my hungry baby from the nurses. Refused.
That’s terrible!
KG “Far more often is the new mom who wants to breastfeed. She tries unsuccessfully and gets handed a bottle as soon as she reaches the postpartum floor…especial post-op and on night shift.
Really? Whose anecdote is this? Yours?
My counter anecdote: I was post-op at night with a flat nipple, and I got a collection of sometimes helpful and sometimes harmful nurses and LCs whose advice contradicted each other, and I walked out of the hospital with a pump. My baby weaned to food. And that was ten and a half years ago, before the hospitals all got “Baby Friendly.”
“To blow out of proportion the misfortune of a cancer survivor’s story in order to promote one’s own anti-lactation cause is foolishness.”
Your dismissal of Emily Wax-Thibodeau’s story only shows your own lack of empathy. Foolishness? The foolishness lies in the fact that you think promoting lactation is more important than understanding biology.
There is no anti-lactation cause here. There is a do what is best for your family cause because the difference between formula and breast milk is very small in developed countries.
Here’s something I always like to think about for these types of statements. Remember the implicit part:
All else being equal breastfeeding is the best option.
The problem is that, in any individual case, all else is never equal. NEVER. And sometimes, due to those other circumstances, for a given person, breastfeeding is NOT the best option.
Consequently, it’s not right to tell any individual person whether breast is best or not just because it is generally true for the population.
Looks like we’ve got some great debate going on here, fantastic. I apologize for not having a lot of time at the moment (new mom) forgive me for starting a new post with some (what I feel) are relevant abstracts as requested. I will try and go through each post soon, I most definitely want to discuss. These topics are becoming more widely accepted and I personally don’t see them as controversial or against dogma at all. The goal here is not to “be right”, it’s to be open to ideas that you may have once dismissed. A paradigm shift for some of you, if you will.
To the poster interested in c sec/mode of delivery and risk of T1DM:
http://www.ncbi.nlm.nih.gov/pubmed/24951818
http://www.ncbi.nlm.nih.gov/pubmed/22829848
http://www.ncbi.nlm.nih.gov/pubmed/18292986
Gut microbiome associations with T1DM development:
http://www.ncbi.nlm.nih.gov/pubmed/24930037
http://www.ncbi.nlm.nih.gov/pubmed/24767831
http://www.ncbi.nlm.nih.gov/pubmed/24475780
I would love to discuss more, but here is at least a basic intro for the discussion. Any and all opinions welcome.
Ahh, bibliography salad!
You are only allowed to cite papers you have read in full. I presume you have read none of them since you clearly have no idea what they say.
Read them (the entire paper, not just the abstract) and then get back to us.
Agreed 100%. Will get to that. I can tell you were a prof…your “bibliography salad” comment made me laugh out loud!
You admit to not having read the full text of the articles…but you want to swoop in here and tell us that we’re all wrong claiming to know the “recent evidence based peer reviewed research”. You haven’t even read it yourself!!!!
Incorrect. This is such old news to me that I honestly cannot remember each and every relevant literature I have ever read. I did state it was only fair to re-read, which I will do at a later date. Do YOU remember each and every specific of every single journal you have ever read? I just had a baby and to be honest, I’m busy with that. Why don’t you attack another poster on here…many of them have been profoundly rude, unprofessional, and downright distasteful.
Sarah “Do YOU remember each and every specific of every single journal you have ever read?”
Heck no! But I’m pretty sure I’ve read a lot more journal articles and textbooks than you have.
Here’s the different between you and me: I’m not posting inflammatory comments on websites without having reviewed my source information.
You are.
Be prepared to explain why you hold your opinions, or don’t post them.
But.. You’re trying to convince us, no? I’m not convinced yet.
YOU POSTED THE LINKS!!!!! I’m not talking about each and every article, I’m talking about THOSE!
I don’t remember each and every aspect of every article I’ve ever read…but if I post the link as evidence for why someone’s actions should be such and such I’ve sure as hell read at least that one. It’s called intellectual integrity. Try it.
OK, the first one is on mice and the abstract concludes: “However, no effect of delivery mode was seen on diabetes incidence or insulitis development.”
Number 2, a case-control study of children, may have found an association between Type 1 diabetes and c-sections, or may have found a link between diabetes and birth weight. It’s unclear.
Number 3 is a meta-analysis published in a fairly serious journal, which is more convincing. It found an odds ratio of 1.23, which was 1.19 ( CI 1.04-1.36) after adjusting for a few confounders. So, there may be residual confounding, or there may be fire under the smoke, to the tune of a 20% increase in risk. And since the base risk of Type 1 diabetes in childhood is not all that large, I’m still not stressed.
Definitely, the NOD study did not show a clear effect. However it was still interesting to see the immunological changes. That is why I posted it.
There are most certainly cofactors, but in my opinion (and yes this is my opinion here) I do think there are enough studies showing independent risk in mode of birth, so to throw the baby out with the bathwater and dismiss the possibility of flora, mode of birth, and disease risk is premature. If not foolish for us to do.
Further study, yes. Immediate change in recommendations or practices, no. I will not disregard a clear immediate danger for a hypothetical danger, years in the future, supported by tenuous early evidence.
And if the findings connecting gut bacteria and diabetes are sustained, I believe that the answer is good quality probiotics, made responsibly by real drug companies, administered at the right time, whenever that is. One of the mouse studies you linked to suggested it might be possible to prevent diabetes in just that way, by modifying the microbiome after infancy.
The great news in this is that IF (and only if) the referenced study is reproduced in humans, this means that while colonization at birth may impact disease risk, that risk can in fact be modified.
The exception to this may be a case such as (and I hate to use T1DM yet again) when a immature gut is exposed to foreign proteins BEFORE treatment occurs. If we assume that cow’s milk proteins (I.e. in formula) for example do in fact contribute to disease risk in a subset of autoimmune T1DM. Gut flora appears to be part of the puzzle, possibly by influencing permeability but perhaps direct immune response as well. Unfortunately, for those cases, it may be too late. For this group, mode of delivery may indeed have a lasting impact. Colonizing at birth, something I mentioned in my initial post, would be an option.
Yet you would make recommendations and urge people not to use even ONE dose of formula based on *if*.
Do some research as to how even ONE dose, yes ONE dose of formula impacts gut flora. Then re-read what I wrote above. Then get back to me. If I bother checking back. A few people want to discuss the topic of this blog. The rest of you…well, to be honest, I don’t know what your problem is, but hopefully a good psychiatrist can solve it.
Sarah “Do some research as to how even ONE dose”
Post your source(s) to actual scientific research.
Papers you have read, and can link to.
Otherwise, we will all assume you are still just making stuff up hoping to sound knowledgeable.
YOU are the all-knowing one here. YOU provide the evidence.
Extraordinary claims require extraordinary evidence.
Show me that (1) it changes and (2) it’s significant enough to allow a child to suffer rather than use formula.
You have yet to back up your OPINION in any verifiable way whatsoever. Of course we’re not impressed.
Flounce away.
Sarah “If we assume that cow’s milk proteins for example do in fact contribute
to disease risk in a subset of autoimmune T1DM. Unfortunately, for those
cases, it may be too late. For this group, mode of delivery may indeed
have a lasting impact.”
You are not making sense. Are you discussing mode of delivery or cow’s milk proteins? Which one this time?
Both. In the case of T1 at least. If intestinal permeability is impacted by colonization at birth, specifically increased permeability due to specific flora colonization seen after non vaginal delivery, then intact proteins, in this case as seen in early formula exposure, may trigger a disease process they may not have had the gut been less permeable.
Sarah “Both”
“increased permeability due to specific flora colonization seen after non vaginal delivery, then intact proteins, in this case as seen in early formula exposure”
Why do you think that non vaginal delivery is related to early formula exposure?
Please be specific, and I am expecting that you have read and understood any paper you cite and post a link to the paper, not just the PubMed abstract.
I will once again ask that you answer the question in your own words. That means: don’t cut and paste abstracts without attribution (i.e, try quotation marks for the parts you are pasting).
IF IF IF IF IF IF IF IF IF IF IF IF IF IF IF IF IF
And what if you’re just pulling all of this out of your nether regions?
What if there are people here who are actively engaged in research into the microbiome, autoimmunity, and inflammation in various combinations, and you are causing their heads to hurt and have reverse key marks on their foreheads?
For your second batch, the first is very interesting. Of course, the samples were taken post diagnosis, so we don’t know whether the variation in gut microbes was a cause or a result of the onset of diabetes. If the microbes did trigger diabetes, we don’t know what caused the abnormal microbes. It is highly unlikely to have been conditions at birth, since microbiome changes drastically through the first year of life.
Agreed. I will try and find the literature that refers to abnormal gut dysbiosis PRIOR to disease onset (in those strongly genetically at risk who where studied). It’s been a long time, admittedly I can’t recall. One current focus of study is in fact early dietary infant feeding practices, as well as mode of birth (among other factors but not sure if we should touch on those). The whole idea behind my initial post was that this topic should NOT be immediately dismissed and ridiculed, when in fact there IS data that APPEARS to support it. I think we ALL can agree further study is warranted.
We’re not dismissing the topic. We are dismissing your calls to make changes to medical practices on the basis of a couple tenuous abstracts you managed to PubMed.
I think it would serve everyone best if you keep an open mind despite the ‘skeptical’ nature of your blog. Recent evidence based peer reviewed research (perhaps this is part of the misunderstanding as you have not been a practicing physician recently according to your bio) does in fact show exactly what is claimed. In fact, early gut flora may confer protection against, or predisposition to diseases such as asthma, Type 1 (autoimmune) and Type 2 (insulin resistance) diabetes, atopic disease, Celiac Disease, and obesity. Our genes are a complex interaction between the bacteria that live with us (and in us) as well as the global environment at large. Although the cause for the recent increase in the above diseases is likely multifactorial, evidence is certainly coming in that the claim these people are making is not radical, but rather “old news” to those in this field of scientific research. One solution is for mothers to “colonize” the infant with vaginal flora (hers or a healthy medically screened donor) at birth, should vaginal delivery not occur. Avoiding ANY formula feeding (which is detrimental to gut flora) and using banked donor milk along with probiotics are considerations as well. I prepared with all of the above, however I was able to birth my son vaginally (I was anticipating a C-section).
If anyone is interested, pull up some abstracts on good old Pub Med which clearly state that the risk of Type 1 diabetes for example, is increased with non vaginal delivery, when controlling for other factors. So the idea that early colonization with vaginal flora vs standard “hospital flora” and/or antiseptic agents has no long term impact on health one the child gets home seems to be flawed. However, one may also argue that a woman with Type 1 diabetes giving birth vaginally may simply pass on that susceptible flora to her offspring, further increasing the risk of the disease (aside from susceptibility genes). My point is that this topic should be accepted as a new frontier of medicine, perhaps the most important one, and not simply dismissed because the people promoting this film believe in some things you don’t.
Found that good old pub med article you were citing. It gets better once you get past the title and the first paragraph
“Yet, not all high-risk children delivered via C-section develop T1D (4). In a Norwegian case-control study, a PTPN22 (protein tyrosine phosphatase, nonreceptor type 22) polymorphism has been shown to increase T1D risk if the child was delivered vaginally (7), underscoring the importance of exploring potential interactions between perinatal exposures and susceptibility genes in the pathogenesis of T1D. Genome-wide association studies have identified the IFIH1 gene to be associated with T1D (8). IFIH1 is a helicase enzyme that produces type 1 interferon in response to viral infections, such as enteroviruses. ”
The link is casual, not scientific and the vaginal flora issue is a bunch of malarkey.
You may want to speak to the Mayo Clinic researchers who currently are looking at developing a commercial therapeutic biologic that contains specific strains of vaginal flora. I suppose you don’t work there. This actually was not the article I was familiar with. Regardless, there is no indication the topic deserves no further attention. That would be a foolish conclusion in and of itself. Malarkey is not a word I would use. I suggest you don’t use it either in this topic.
You caught me, I don’t work for Mayo. Even so, I can back up what I quoted.
Here is the article I was referencing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3237660/
When Mayo clinic shows that vaginal flora somehow assists the mother and baby then I will be happy to use less offensive words and discuss it more freely. In the meantime, it is a theory that could easily be used to justify vaginal birth as the “superior birth”.
The gut flora, and probiotics have been long discussed and encouraged, that’s another issue entirely in my opinion. Even then, linking the diseases you mentioned to c-section and formula feeding feels like another scare tactic to me.
Your argument here is lost on me, sorry. It’s not really what I’m here to discuss. I don’t really care about what one considers “superior” or “scary”, I just want to examine the data we know and be open to evaluating the topic.
What are you here to discuss?
Exploring the interaction/interplay of bacteria (“good and “bad”) with genetics early in life, and factors affecting such. Primarily birth interventions (hence this blog post) but I briefly meant to touch on infant feeding as it also appears to have an impact (further study is warranted). My main interest was mode of birth, as per the documentary mentioned by the blog author.
Okay – mode of birth.
Mode of birth clearly has some effect on the infant microbiome – nearly everything does. However, the lifetime effects of the infant microbiome are subtle, and hard to disentangle from other factors. Birth decisions are usually made on the basis of present, immediate risks and decision factors, with known and obvious effects in both the short- and long-term. These concerns outweigh the issues of health problems which might or might not eventually arise as a result of microbiota.
“However, the lifetime effects of the infant microbiome are subtle, and hard to disentangle from other factors”
Unless, of course, the microbiome that an infant inherits from its mother’s vaginal flora contains group B strep. GBS sepsis is pretty un-subtle.
“Unless, of course, the microbiome that an infant inherits from its mother’s vaginal flora contains group B strep. GBS sepsis is pretty un-subtle.”
Unless, of course, that GBS sepsis is brewing in the dimly lit confines of home and hearth under the supervision of those who had never had the “privilege” to witness enough such progressions. Then it is pretty subtle too … until, of course, it suddenly isn’t.
so true
OK, you’d like to talk about bacterial interactions with genetics and early life factors. I’m a microbiologist, I’ll bite. Which bacteria do you define as ‘good’ and which are ‘bad’? Genus and species please.
Hmmm, crickets. What a shocker.
Pablo’s Law strikes again!
” This actually was not the article I was familiar with.”
If you are “familiar with” it, why don’t you just tell us which one it is? Who is the lead author and what journal? Why be so coy, why not just tell us?!
Sarah “pull up some abstracts on good old Pub Med”
It’s your claim. That means it’s up to you to post the links.
You have actually read the papers, right?
I have, but admittedly I’m lazy and a new mom. A bad mother in fact as I appear to be wasting copious amounts of time here. I may pull some up in the next few days. They are there however if anyone is particularly interested. Or bored.
Sarah “I have, but admittedly I’m lazy”
Then why are you trying to have an argument with people?
If you are too lazy to present the folks reading here with the sources for your opinions, please stop wasting our time.
Your first mistake is assuming I am arguing with you. I’m not.
The “debate” started when I made a post about infant formula and it’s effect on gut flora (the topic at hand) and everyone who has ever formula fed had something to say about my non controversial statement.
But that was not the original intent.
Your posting history is compelling evidence that you’re arguing.
If you don’t want to debate, stop debating. Log off and go to bed.
If you want to keep talking, respect the conversation enough to pull some citations.
I am heading to bed. I can try and post some links over the weekend.
My intent was more to share knowledge or consider novel information, although it looks like a good debate on here is always appreciated (who can’t respect that). Fair enough.
It’s not hard for an individual to research the information provided however, if you really are interested.
I have researched, and I have come to different conclusions than you, in part because I am looking at different papers. (In other parts, I believe I am coming to different conclusions because I’m smarter than you. If I offend you by suggesting this, I am sorry you have had an emotional expression to my statement.)
If you want to share novel information, you do actually have to share it.
Haha, novel information. Thanks for the laugh.
Earth to Sarah: no one here is going to bow to your intellect just because you think it’s so vastly superior. Links, Sarah, with actual information.
Sarah “My intent was to simply share information”
If you want to share information, you need to share real information – not just your opinions as you have done this evening.
And when you begin your comments with the request that everyone “keep an open mind” you might want to do the same.
I suppose they are opinions to you as I have failed to post a link. However that does NOT mean my statements are not factual.
Sarah “However that does NOT mean my statements are not factual”
No: it’s the ones that have already been pointed out to you that are flat out wrong that are “not factual.”
Sarah, you don’t know everything. Neither do I, nor the others commenting here. You may agree to disagree, but we can learn from each other if we do make an attempt both to teach (not opine) and to learn.
I am going to check back on this post later for your promised links.
Sarah, thank you for illustrating the ignorance, arrogance and desperation of homebirth advocates.
It’s pretty obvious that you have not read any scientific papers about breastfeeding, and lack the understanding of chemistry and biochemistry necessary to understand them even if you did read them.
Imagining that you are knowledgeable about breastfeeding because you have read the propaganda of the lactivist industry is like imagining that you are knowledgeable about extraterrestrial life because you read about aliens in the “newspapers” at the check out line in the supermarket. It would be funny if it weren’t so scary.
Is there a connection between flora and various aspects of health? Yes. Some health effects are clearly linked, other the evidence is still weak.
However, we do not know what the ideal gut flora looks like, and assuming that the “natural” flora are best is a pretty big leap of logic. After all, most of us have gut floras pretty far removed from those of our ancestors, who drank impure water and endured periodic bouts of amoebic dysentery as a result, who ate diets quite different from ours, and who lived with parasites on a daily basis.
We’re already unnatural. Even if c-sections do change gut flora, why should I believe they change it for the worse?
These are the EXACT questions we need to be answering. Studies have shown which bacteria tend to be predominantly found in the intestinal tracts of people with certain pathology (Type 1 diabetes for example) even prior to disease onset. When compared to those who are healthy, notable differences have been found. Now, in those cases, unless the flora of the Type 1 diabetic mother is “corrected” (assuming similar vaginal flora dysbiosis is occurring) in theory it may be MORE of a risk to birth vaginally (although current study suggests assisted vaginal delivery and c sec increase risk of T1DM in offspring). It’s all about personalized medicine, right? However, the literature seems to now indicate that c sec infants in the general population are colonized with the bacteria (often pathological) seen in hospitals, and this does warrant further study.
Sarah “However, the literature seems to now indicate that c sec infants”
Could you please post some links to this literature?
One solution is for mothers to “colonize” the infant with vaginal flora
(hers or a healthy medically screened donor) at birth, should vaginal
delivery not occur. Avoiding ANY formula feeding (which is detrimental
to gut flora) and using banked donor milk along with probiotics are
considerations as well. I prepared with all of the above, however I was
able to birth my son vaginally (I was anticipating a C-section).
It is entirely unbelievable to me that there is a single optimal microbiotic colonization that is ideal for all humans. The microbiome surely varies wildly depending on a wide range of factors – where people live, what they eat, what plants and animals they are in regular contact with, to name a very small beginning number of factors.
So long as donor milk remains (as it is) unavailable to all but the most critically ill infants, parents who have difficulties breast feeding will be faced with a choice between feeding their children formula and not feeding their children. Most parents don’t see this as a choice. We haven’t yet clearly identified the long-term effects of formula on the microbiome or overall health (we can’t identify what’s caused by the mircobiome and what is caused by external factors), but we have a very clear understanding of what happens when you don’t feed a baby.
This is exactly why this is being studied. Personalized medicine. Epigenetics is a hot topic right now, and it’s not limited to in utero development. And you are most certainly incorrect about banked donor milk not being available. I was able to obtain it myself with no significant issue. Term delivery (induction). One must remember that a lack of donor milk does not mean one must throw their hands up and not continue to look critically at formula feeding and it’s effect on health. Perhaps more resources should be pooled into expanding milk banks, and improving the current formula given to infants. First ingredient is often copious amounts of sucrose/high fructose corn syrup. It’s rather accepted that formula feeding increases disease risk, even though most mothers and people taking care of them seem to ignore this.
I would also like to point out that probiotics can be added directly to formula if there is no alternative. True, while it’s unknown as to what is the “perfect” ratio for an individual, it’s rather accepted to prescribe certain strains after antibiotic use for example. These strains are commonly accepted as “beneficial bacteria”. One could conclude that it would be acceptable to use the known strains. Lastly, while there are certainly medical contraindications for not breastfeeding, more often than not it’s a lack of proper support and knowledge among those treating the woman that allows a failure of breast feeding establishment to occur. Very few women truly suffer failed lactogenesis.
A problem with milk production is only part of what can occur with breastfeeding problems. The baby’s struggles affect breastfeeding just as much. In my own case for example I was making plenty of milk for my twin babies. One was gaining weight, one wasn’t. They were both latching properly, but my sweet second born was lethargic from bilirubin levels and was burning calories when he was feeding. The hospital staff conceded that he needed formula, for which I am very, very grateful. When his bilirubin levels dropped, he was strong enough to be breastfed.
My eldest got formula in the hospital for this reason as well – my milk wasn’t in yet, and he was a sleepy nurser with jaundice. That ounce of formula made it possible for us to take him home, and for him to nurse the next day, when my milk came in.
The issue is that ONE dose of formula can negatively impact flora, the topic at hand. Few recognize this. It is not benign.
Generally speaking, milk never comes in right away in most women. This is the biological norm. Yet most infants who are exclusively breastfed with this norm survive. Formula was not the routine as “formula” did not exist.Colostrum is all the infant needs for the first couple of days (with noted medical exceptions). You can hand express colostrum.
Just to be clear, you’re asking if my care providers followed the basic standard of care for a jaundiced neonate – kind of an insulting question, but: Yes. A breast pump was provided. Just as soon as they realized that my son was jaundiced, they brought me a breast pump and helped me use it, and wrote me a prescription for a rental pump to take home, with instructions to pump every two hours to bring my milk in. It took about 24 more hours for my milk to come in.
There was no evidence of negative effects of that formula at the time (he peed and pooped, and looked markedly less yellow within a few hours), and there continues to be no evidence of negative effect 7.5 years on.
You probably know that anecdotal evidence is not exactly evidence, and your son is only 7.5 years into his life. Studies show formula can certainly negatively impact health. And may play a role in flora colonization, the topic. Again, the issue is not for you to defend why formula was used, it’s to demand better formula.
You’ve demonstrated above that you basically have no idea what’s IN formula, or why it’s there, so your belief that formula should be improved has no factual basis.
And if the issue is not to defend the use of formula, why bother to ask whether I had a breast pump? You’ve asked obnoxiously personal questions, and I have politely answered them for the sake of argument. I brought up my experience to illustrate that supply issues aren’t the only reason to turn to formula. If anecdotes are irrelevant, don’t push for people to detail their anecdotes.
Incorrect. If you think for whatever reason, formula is not a poor substitute for breast milk, so be it, we will have to agree to disagree. As a mother, I would demand better, instead of wasting energy defending such a poor product heavily marketed to mothers who usually don’t need it (exceptions noted).
For the record, corn syrup solids is in fact the first ingredient in Nutramingen A+. Pure sugar essentially. Perhaps you’ve never wondered why formula must be so properly prepared (formula is non-sterile (powdered), no immune properties, but also, extremely high in sugar content, perfect medium for bacterial growth). I don’t think it’s me who doesn’t realize what’s in formula.
There are numerous components in breast milk not found in formula, and it’s theorized many have not yet been discovered (so I will not debate the unknown).
Currently DHA has been added to formula (processed with hexane) but it is unknown if it has the same effect as DHA found in breastmilk,. Probiotics in some US brands have been added as well. Again, it’s unclear how active/effective these cultures will be within a premade formula preparation.
Clearly, if companies are still improving formula, even they know it’s not an ideal product.
What have I said that’s incorrect? Which part?
Formula isn’t perfect (we learn more and improve things all the time), but it’s the best substitute for breast milk that we have. Breast milk isn’t always appropriate or available. You insist that you would never feed your child formula, but when I asked what you would feed your baby if breast milk wasn’t available, you basically said “breast milk.”
Formula may not be perfect, but discordant sibling studies strongly suggest that formula-fed infants in first world countries are not disadvantaged in comparison to children who were breast fed.
Nutramigen A+ is another formula for infants with major dietary restrictions (in this case, allergies to cow’s milk proteins). When one source of calories is inappropriate, we have to use another.
When I formula fed my kid, I never sterilized anything. Bottles and nipples went through the dishwasher. I didn’t heat up water for her either – she was perfectly contented with room temperature.
Breast milk contains complex sugars and is also a fantastic medium for bacterial growth.
The incorrect statement was that I do not know what is in formula. I unfortunately do.
If breast milk was not available (including donor milk), I would use a powered amino acid based formula, along with live probiotics. Powered formula is not sterile, but there is in theory less BPA exposure. Ideally commercial formula would not use soy oil, or have such a high glycemic load, or use BPA in the can lining, but those are just my personal concerns.
I think we both know that breast milk is in fact antibacterial, and actually contains a number of immune factors known to fight pathogens. I am quite sure you are aware of this.
Yes, breast milk contains IgA antibodies. These antibodies primarily serve to line the infant’s gut and ward off digestive-tract infections. In preemies, this boost can be life-saving, in term babies, it’s pretty minor.
I don’t think we can argue over the fact that breastfed infants generally have less upper respiratory infections and fewer ear infections, just to name two widely accepted statements. To an infant with asthma (which appears to be diagnosed more often in formula fed infants), a respiratory infection may in fact be serious. I personally don’t like the term “minor” to describe the benefit of breast milk. But I suppose we can agree to disagree.
Discordant sibling study concerning the effects of breast milk can be found here:
http://www.sciencedirect.com/science/article/pii/S0277953614000549
FWIW, the one measure on which this study found a statistical difference between breast-fed and non-breast fed children is asthma. Breast fed children appear slightly more likely to have it. The researchers question whether the asthma finding is completely accurate, but the current data suggests that formula does not put children at higher risk of asthma.
The fact that a statement is widely accepted doesn’t make it necessarily true, or necessarily explain the causation. It is possible, for example, that breast fed children are less likely to attend day care, and therefore less likely to pick up germs from other little kids.
“I don’t think we can argue over the fact that breastfed infants generally have less upper respiratory infections and fewer ear infections…[…]…To an infant with asthma (which appears to be diagnosed more often in formula fed infants)…”
Actually, your assertions are not supported by well controlled studies. It is true that breastfeeding is CORRELATED with fewer respiratory and ear infections and less asthma, but that is due to confounding (e.g. respiratory infections are picked up at daycare, and babies who go to daycare are more likely to be bottle fed. Asthma is more common in the inner city, and inner city babies are more likely to come from high poverty groups where breastfeeding is rare). But studies that are *controlled* do not find higher rates of respiratory illness, ear infections or asthma among formula fed babies. Discordant sibling studies and the Belarus PROBIT study papers are an excellent place to start to bring you up to speed on the science. Both have been discussed extensively on this site. You can search in the right hand column.
You’ve made claims about the contents of formula that aren’t born out by reading the nutritional labels, and claims that the ingredients are bad that aren’t born out by thinking about them.
Breast milk to some extent retards the growth of pathogens, but it contains hundreds of species of bacteria, so no, it’s not antibacterial.
My terminology is incorrect, agreed. I was referring to pathological bacteria, but I assumed you would assume that.
Please look at a can of Nutramigen. The first ingredient is corn syrup solids. Soy oil (a refined cheap filler) is also down the line. Alimentum lists sucrose as ingredient number two.
I don’t know what most mothers feed their children, but I certainly don’t think a diet of sugar and refined processed oils is conducive to good health. Perhaps I’m on an island…
I did look at the ingredients of Nutramigen. Corn syrup solids are indeed first on the list. And sugar is the third ingredient in powdered Alimentum. Both of those formulas are intended for babies who can’t have either certain or all proteins. Alimentum is also intended for babies with fat malabsorption. These formulas contain huge amounts of sugars because they are intended for infants who can’t get many calories from other sources.
Soy oil is in formula as a source of fat, which is vital for brain development. It may be refined and cheap, but it’s not just filler.
I would prefer a better quality oil to be used. Olive oil, coconut oil, are two examples.
Often coconut oil is used, I will point out. However, I think there are too many unknowns about soy to say it should be used in infant formula at this point.
Sucrose is the second Alimentum ingredient in the liquid form.
Sarah, how are you evaluating the quality of oil? Coconut oil is primarily saturated fats.
Olive is primarily monosaturated, and soy polyunsaturated, similar to sunflower or safflower.
I really want to know the answer to this question. Besides the saturated/monosaturated/polyunsaturated question, I wonder about shelf stability, flavor (olive oil is very strongly flavored) and allergens (I live with someone with a coconut allergy).
I also wonder about cost – the expense of formula is a frequent complaint, and both coconut and olive oil are comparatively pricey.
ImI’m going to go with: Mercola or WAPF.
Ah yes, just like in nature, where tiny little fetuses swing from the coconut trees, harvesting coconuts and pressing them into oil.
One oil is not more natural than another. Both are created through wholly unnatural processes.
What unknowns about soy are there?
Actually, my son’s formula contains coconut oil, soy oil and sunflower oil.
Keep in mind that healthy fats for a baby are different from healthy fats for an adult: In adults, large quantities of saturated fat are linked to high cholesterol and heart disease. In babies, saturated fat is gobbled up and used for essential brain development, without lingering in the arteries.
Sarah,
Do you realize that most probiotic bacteria don’t colonize your GI tract? That’s why you need to take them everyday. Otherwise one dose of probiotics would be sufficient wouldn’t it?And with these probiotics, are they ‘beneficial bacteria’ that have been identified from adult GI tracts, or infant GI tracts?
The effects of untreated jaundice include possible brain damage.
Gut flora! Not the most important thing.
Not always. Depends on the cause/onset and how high the levels actually are. And formula is not an automatic cure for jaundice and should not automatically be given IF (and only if) breastmilk is available. That was my point. Often formula is given almost like a pharmaceutical, a “necessary” drug. The topic is gut flora. I stand by my comments within the context. I’m sorry you seem to have some sort of emotional expression to the topic.
I can’t imagine why anyone would have an emotional reaction to a dead or brain-damaged baby, can you?
Yes, not all jaundice is serious. Something like a third of babies are visibly jaundiced, and most are totally fine, but around 3% develop bilirubin levels high enough to be dangerous.
And, ounce for ounce, formula clears jaundice faster than breast milk. Period.
Do you have a study I may review that states that formula instead of breastmilk results in better outcomes or at least supports your statement. I’m admittedly lazy tonight, sorry.
Very well known among neonatal specialists. One source is this, starting in the second paragraph:
http://www.medscape.com/viewarticle/497028_6
Great read thanks.
“Milk-based formula inhibits enterohepatic circulation and may help lower serum bilirubin levels in breastfed infants.”
Do we know of any long term effects in using this method? What I mean is, what impact can we speculate early milk formula exposure has on normal infants in terms of metabolism (if any?).
Well, for one, fewer babies suffer from the effects of jaundice.
Sometimes the short-term effect outweighs concerns about long-term effects.
Before I started radiation therapy, my radiation oncologist sat down with me to review the risks. Undergoing radiation meant that I would have a 1-2% chance of developing leukemia. But not undergoing radiation meant that I would have a 33%-50% chance of a recurrence of my existing cancer. So how much do you think that leukemia risk affected my decision?
There are many analogous issues in almost many medical decision, including prenatal care, c-sections, and infant feeding.
“Great read thanks.”
Seriously Sarah, was this the first you had ever heard re formula vs breastmilk and bili clearing?! Sarah, this is neonate care 101. This is basic info that every medical student learns during his or her OB rotation. You have come to this forum attempting to “educate” everyone else, but there are HUGE gaps in your basic knowledge. Dunning Kruger at its finest.
I suspect the *important* long term effect is that the infant will survive without brain damage. That may be what they’re concentrating on, here.
Full marks for mastering the non-apology.
I’m sorry you seem to have some sort of emotional expression to the topic.
…
As a mother, I would demand better, instead of wasting energy defending
such a poor product heavily marketed to mothers who usually don’t need
it.
…
I don’t know what most mothers feed their children, but I certainly
don’t think a diet of sugar and refined processed oils is conducive to
good health. Perhaps I’m on an island…
You’re an asshole.
What are you suggesting here, Sarah? Oh Elizabeth A, you poor thing, just wait! When your son turns 75, he’ll become very, VERY ill, and it’ll be proved without doubt that it was because of that single time you fed him formula.
I thought I had seen it all where breastfeeding Nazis and cruelty were concerned but you show me how naive I am.
Well, Sarah, since we’re at it, how do you know that the cow, err, fresh donor you used to feed YOUR child doesn’t get some health troubles that weren’t known at the time and so weren’t in her medical records? How do you know that you haven’t gotten YOUR child sick via another woman’s breastmilk?
Oh, not to worry Amazed. My son was a walk in the park compared to my daughter, for whom we fortified breast milk with Enfagrow (which I may be misspelling – it’s been a while). Heaven only knows what that did to her gut flora.
My doctors assure me that the breast malignancies probably had no effect on milk, but it sure is a thing that’s kept me up a few nights.
Oh but I don’t worry, Elizabeth. At all. I know formula was good for your son.
Respectful self-appointed guru Sarah doesn’t worry either. On the contrary, she’ll gloat if an issue with your son appeared in the future and she’ll happily relate it to that ONE dose of formula, even when there’s no basis. She will show you how much cleverer and WAY a better mom she is!
I am sure the breast malignancies issues kept you worried! Good to see you sound as you’re over it.
The issue is that ONE dose of formula can not only save a baby’s life, but actually salvage a breastfeeding relationship.
Many primitive cultures do supplemental feeding during the first few days of life. Some historical evidence suggests that, in ancient times, first babies had particularly poor survival rates, and slow lactogenesis following a first birth may have been a significant part of it.
“Impact on flora” versus death. What a difficult question.
Also, other evidence suggests that those early difference in gut flora fade, and once babies start eating a variety of solids, they more or less disappear.
most infants survive
how comforting
“The issue is that ONE dose of formula can negatively impact flora, the topic at hand.” This is scaremongering crap, and the reason that I suffered through months of exclusive breastfeeding with low milk supply, too scared to give my daughter a single bottle of formula. This is exactly the argument that led me, a tired, new mother with “breast is best” being shoved down my throat, to try to comfort my hungry, screaming daughter with empty breasts instead of a full bottle of nutritional goodness.
I thought that too! My mom who is a big believer in breastfeeding appropriately freaked when she saw how badly my baby was doing. She calmed me down and told me she believes that formula changes the digestive flora but that’s not negative, just different. I cannot understand why lactivists continue to encourage struggling moms when it’s evident that both mom and baby are miserable. I am really thankful that I wasn’t surrounded by that claptrap as a new mom.
Oh so she should have declined that ONE dose of formula to allow her child to continue to be jaundiced and in the NICU.
“Most infants…survive” – yes. And Elizabeth was rather committed to her baby being one of them.
In many cases, expressing breast milk with a breast pump is also effective. I assume your child was also treated for the bilirubin medically if formula was suggested.
Expressing milk was not an option presented to me at the hospital and of course he was treated for the jaundice. My point is simply that there are man reasons why mothers formula feed and whatev
While I do think it’s not in the best interest of the infant to NOT have the medical team suggest expressed breastmilk (noted medical exceptions aside), my point remains that I’m not sure why all of these posts are explaining WHY someone formula fed and the justification for it. Where did that come from?
My posts have all been on gut flora, and the impact of mode of delivery/feeding, which happened to include a comment regarding formula. My focus is on the topic, not formula per se.
If someone does not like what is known about formula, they should be informed of other options, or take it up with the manufacturer.
If a patient reacts to a pharmaceutical, very rarely do they get angry with their pharmacist or neighbor who did not take the drug. They sue the company. Don’t shoot the messenger. If for whatever reason you are absolutely fine with formula, I’m not sure what benefit it will be for someone like this to review any data on it.
I’m just confused as to why people keep bringing up the formula comments, when it was initially such a small part of my initial post.
Probably because most of what you thought you knew about formula was wrong, from the nutritional content and ingredients to the reasons people use it.
“Not in the best interests of the infant”
Says the lay person with no medical training despite published evidence that formula clears jaundice faster than breastmilk. Whether it comes from the boob or a bottle, the formula is better than the breastmilk.
My baby was the same story, sort of. Except his poor latch and high bilirubin levels took about a day longer than they should have to be diagnosed, which meant his bili levels passed 20 and he needed overnight treatment in a NICU with IV fluids, lights and aggressive bottle feeding. We never did establish breastfeeding after that fiasco.
I have no idea where on earth you are, but screened donor milk was specifically NOT available to me when my daughter was premature. Basically, unless preemies were critically ill in a way that made formula specifically problematic, my local hospitals didn’t have it. Donor milk is not an available solution for many of us, and given how little screened donor milk is available, I favor limiting it to babies who are critically ill.
Furthermore, disease risk is generally not the basis on which we make infant feeding decisions. That’s because disease risk is a long-term issue, and what to feed the baby today is a problem requiring an immediate solution.
It’s unfortunately common for people who strongly favor breast feeding to insist that supply problems are uncommon, to behave as though supply problems are the only breast feeding problems there are, and to claim that women who don’t breast feed merely lack “support.” All of these assumptions are incorrect and infuriating.
Discordant sibling studies on breast feeding indicate that the biggest
difference between breast fed and non-breast fed infants in the same
families is that breast fed infants are slightly more likely to have
asthma.
While I was nursing and pumping for my daughter, I commonly pumped 30 or more ounces of milk a day (in addition to nursing her directly – I had intractable oversupply – it hurt). I had a part-time live in nanny, wonderful daycare arrangements, a supportive husband, and helpful family living nearby. I also had post-partum depression and anxiety that made me nearly unable to function.
Formula is indeed made with corn syrup solids. It enabled my daughter to thrive and grow, freed me from the breast pump and the crying jags I was having during pumping sessions, allowed me to take appropriate medications without fear of them affecting the baby, assisted me in my return to work, and gave me more time and energy to spend with my children.
Health is not controlled by any single factor, and so there is not any single route to the desired end. Formula is a healthy choice for many families, for many reasons.
We must demand better formula options. Most of us would not give our older children foods with the same ingredients in infant formula. I most certainly would not. It is accepted that there are most certainly long term health risks to formula feeding. Regardless of what one may want to believe. If you want, feel free to read one of the many articles linking formula feeding to an increased risk of Type 1 diabetes (no one is denying one must have genetic susceptibility however). The risk here is largely due to intact cow’s milk protein (molecular mimicry possibly) but may also be due to unfavourable changes in gut flora, which has recently been linked to T1DM, among many other diseases. That being said, we should focus on the flora issue, as this is the topic at large. Formula does seem to have a negative impact on flora, period.
1. I’m feeling fine about how well, or not, I stick to topic. Infant feeding and human health are complicated topics. We can’t discuss them in any realistic way without ranging all over the map.
2. You’re making statements about gut flora that I don’t think can be substantiated. Formula certainly changes gut flora. So does living with cats. It is not clear EITHER that these changes are necessarily harmful, or that they persist beyond the introduction of solid food, when all gut flora changes radically.
3. The formula option we have seems to work pretty well – see those discordant sibling studies. In what way would you want it improved? You’ve complained about corn syrup, but have you actually read any formula labels? I was curious this evening, so I looked a bunch of them up. In almost all cases, the first ingredient was non-fat milk. The one exception I found was Earth’s Best, which starts out with “Lactose.”
I do stand by my comments as they pertain to the topic at hand. Early (including very early) infant feeding practices are now emerging as a potentially huge factor in both short term and long term health. As well as prenatal environment, but let’s disregard this for now as we are not discussing flora in utero (apparently it’s not a sterile environment contrary to previous belief). There is no benefit to those caring for mothers and infants to ignore the fact that infant formula is well, junk food for infants. I would never give an infant’s immature gut intact or even partially hydrolyzed food proteins such as found in cow’s milk or soy formula if at all possible. But even with the fully hydrolyzed or amino acid based formulas, HFCS or sucrose is still present in copious amounts (if not the actual first ingredient). I do not think most of us would assume this is beneficial to gut colonization, or at least overall health. Again, better options need to be provided to those who must use them.
“Junk food” with a macronutrient balance identical to that of healthy breast milk, and superior levels of many micronutrients.
Riiiight.
Incorrect. Breastmilk actually contains much more fat, including cholesterol. Which is why it’s hypothesized that adult livers of breastfed infants can metabolize cholesterol better (formula fed adults tend to have higher cholesterol). There are other explanations of course but that is one.
The glycemic index and glycemic load is also much higher. Infants formula fed have a much higher insulin response. So much that in theory giving formula to an IDM may actually increase the risk of hypoglycemia due to excess insulin secretion in response to formula.
May I ask why you think formula is identical to breast milk composition when it’s not?
Of course there are immunological factors as well but that is not what you were suggesting.
Can you please post some citations that support some of these claims you are making? Is there one study that supports this, or are there several studies that come to the same conclusions, because one study in and of itself proves nothing. Also, you are basically insinuating that I have irrevocably harmed my children by offering formula in addition to breast milk due to my lack of knowledge. I find that a touch insulting and condescending. If what you are claiming is so obvious, then it would be widely known. And if you claim this knowledge is being suppressed by formula manufacturers and doctors and the thousands of others who would have to be in on the secret, then I will know just how seriously to take your claims. Conspiracy theories are not an effective way to make me take people seriously.
The research into gut flora is very interesting, but it is in its infancy and (legitimate) researchers will tell you we know very little that can be considered concrete. There is a lot that is coming up in early research that warrants further, larger, better constructed studies, but I venture to guess that nothing of what you have claimed has been proven. Suggested, perhaps. Worthy of further study, perhaps. Proven to the point that you are saying? No.
She said the macronutrient balance is identical, not the composition.
True. Since noted above. I actually realized this before your post. Thank you.
According to this study, most women have between 3-4% fat in their milk: http://ajcn.nutrition.org/content/41/4/787.full.pdf.
Formula contains 5.6 grams of fat per 150 mL, which works out to (Oh, snap!) 3.7% fat.
A century ago, doctors were sad and angry that so many babies suffered malnutrition or died because their mothers couldn’t lactate and they were fed poor substitutes. Wet nurses helped sometimes, but not all women could afford them, and the practice sometimes spread tuberculosis or syphilis.
So, they sat down and studied some breast milk. They determined its chemical composition, and then determined that a special formula consisting of cow’s milk, water, and sugar would provide fat, protein and carbohydrate in the same quantities as breast milk. That first infant formula saved a lot of babies, and since then science has refined it quite a bit more. Infant formula is, in short, the nearest duplicate of breast milk that we can produce.
The real question is, why don’t you believe it?
Perhaps I should have stated composition/ratio of fats. And the glycemic load was not addressed. Snap? What exactly do you mean by that?
I also don’t get your argument. It’s the only alternative to breastmilk that is commercially available. Hence why it’s the “nearest” by default. That doesn’t make it even close to breastmilk. It’s not me to argue with. It’s the many studies linking formula feeding to the issues we have already discussed. My argument still stands.
OK, so you claim that formula and breast milk are not nutritionally similar. Check.
Evidence, please. Specific nutrients, and a source to support your claim. LLL is not an acceptable source.
Sarah “It’s the many studies linking formula feeding to the issues we have already discussed. My argument still stands.”
You have not presented your argument: where are the links to the literature (i.e., research papers) upon which you base your ideas?
I have read four infant formula nutrition labels this evening (Enfamil, Similac, Earth’s Best, Up & Up). None of them mentioned high fructose corn syrup. Maybe it was there under another name – feel free to take a look yourself and let me know. I don’t recall seeing sucrose, but I wasn’t specifically looking for it. If you spot it among the first ten ingredients on one of those labels, do let me know.
What would you feed your infant if you were, for some reason, unable to breast feed, and donor milk were not available? Because all of your protests that you’d never give your child this or that don’t mean a lot if that means there is no food that you could give your child.
Fresh milk directly from a local donor(s) whom I was able to secure her medical records (ensuring minimal risk of STI transmission and ensure no pathology or contraindicated prescriptions). Most mothers have the ability to learn how to pump and store breast milk safely .Even better if the donor has an infant approximately the same age. But that’s just my private preference since you did ask. You can also pasteurize your own donor milk if you really wanted to.
Similac Alimentum lists sucrose as one of it’s top ingredients. Corn syrup solids is probably what you’re looking at and not registering it as such. Most people, including those who care for mothers and infants, never really read the labels on cans of formula. It is essentially junk food/sugar water for babies.
The issue is that for those who must rely on these so called “formulas”, better ingredients must be found. I question the use of “soy oil” in almost every formula (cheap filler). Highly processed with estrogenic effects. However, again, this is not related to flora so I will not discuss further of course.
I asked what you’d feed your child if donor milk WASN’T available.
Remember that oversupply I mentioned? I wound up donating a lot of milk informally, because milk banks won’t take mine (issues from travel in my twenties). Nobody asked me any questions. They certainly did not request medical records. These very desperate people would drive for hours to show up at my door, at my convenience, and take what milk I had, which was never sufficient to entirely feed their children. The experience leads me to believe that there’s not a lot of choice for families who want donor milk. All the babies who got my donated milk also received formula. When I decided to stop pumping for my daughter, I preferred not to seek informally donated milk myself. I preferred formula.
Similac Alimentum doesn’t list sucrose at all. The third ingredient is sugar. Alimentum is intended for babies with protein intolerences, protein malabsorption, or fat malabsorption. If you can’t get calories from fat or protein, you still have to get calories somehow – hence sugar. I’m happy to discuss infant formula ingredients only if you’re willing to look at what they really are.
Sucrose is table sugar.
And for the record, sucrose (table sugar) consists of a molecule of glucose and a molecule of fructose linked together through a dehydration process (removing one unit of water).
Lactose is a similar sugar consisting of one glucose and one galactose unit and is the main sugar found in milk – any milk.
Oh FFS. Stop siphoning donor milk away from legitimate milk banks.
It’s not junk food for babies. It’s complete nutrition for babies. You’re a chemophobe.
Actually Trixie, as I read this post, I don’t think it was from a donor bank. She used “local donors” and SHE looked at their medical records. Sounds like Craigslist milk to me.
Still siphoning it away from legit donation channels. Imagine if there was a widespread black market for blood donation, even a nonprofit one, where everyone got to decide for themselves who to give their blood to. Might that not cause shortages?
There’s a limited number of women who can pass lifestyle and medical screening, who have the extra milk, the time and will to pump, and can follow the directions to do it safely. Some of those women turn to HM4HB or Eats on Feets because it seems easier or that’s what their fend did or what they read about on a message board. Or they believe that pasteurization will destroy it somehow because that’s what they read on milk sharing Facebook pages.
All of this hurts the real milk banks.
Incorrect. I used an actual milk bank. I’m not sure what your unprofessional comments have to do with the topic at hand. Just because my son was term, it does not mean there was no medical need for donor milk.
What was the pediatrician’s diagnosis then and reasoning for not using formula?
You’re lying. An actual milk bank would never give the medical records of the donor to the recipient. Never. They screen the donor and then keep that information confidential.
Heck no that’s not Craigslist milk. I donated milk that way (in my defense, the official milk banks ruled me out as a donor). No one ever checked a darn thing. I was sure as shootin’ not asked for my medical records, and I absolutely would not have provided them if requested. (Specific test results, maybe. All the records? Hell no.)
The demand for informal donor milk is such that donors can pretty much set their own terms. Some of which are very skeezy.
You realize that all milk has a lot of sugar in it, right? Sugar is energy. That’s all. Your breast milk has sugar. Formula has sugar. It’s not that hard to understand.
How did you know the donor was the owner of the medical records you reviewed? How do you know the medical records you reviewed covered everything they needed to cover? How do you know the ‘donor’ you met actually was the donor of the milk? How do you know the donor wasn’t taking drugs that might affect your baby? How do you know what you were picking up was in fact breastmilk? Assuming it was, how do you know the standards the donor set for herself in keeping everything clean and refrigerated were adequate?
You trust some total stranger to provide the primary food for your baby but won’t use a commercial substitute because you misunderstand what you read on the tin and what your baby needs to survive and grow? In doing that you expose the baby to who knows what toxins and infections: if I was the judgemental type I’d be judging you like crazy by now.
Dude, do you realize how much sugar is in breastmilk?
I am reminded of a hilarious conversation I once read between two dudes, with dude 1 swearing up and down that ‘healthy’ breast tissue is made up of something other than fat.
Sugar is bad, breastmilk is good, therefore breast milk must be some magic form of lactose that doesn’t actually contain saccharides.
Both my kids nursed long enough to have memories of it, and both of them say the same thing: “it was really sweet.”
“infant formula is well, junk food for infants”
I get so sick of the food prudes. What motivates them is a desire to make themselves seem special and more righteous. It’s a form of social aggression and it’s not new–food prudery has been used by cultures for millennia to create us/them distinctions and enforce social castes. Lactivists are just the latest to play the game. At least leaders of the major religions now acknowledge that their food rules are symbolic not scientific, and following them doesn’t literally make you a more “pure” person. Not so for those who worship on the altars of Lactivism, non-GMO, Organic, or HFCS Hysteria.
I think there are two factor at play here. First, it is a away for the upper middle class to separate themselves from the unwashed masses without the snobby implications of judging based on cloathes, neighborhood, and cars. My mothers generation used to judge based on the school you went to and this one it’s based on the food you eat.
Secondly, you have the whole talisman issue. Everyone has it in the back of their mind that one day their bodies are going to fail them. By eating organic, probiotic, GMO free food people can convince themselves that it won’t happen to them. They won’t get cancer, or diabetes or heart disease because they’re doing everything “right.” Nature doesn’t care if you are being a good boy or girl and eating all the “right” things. Your body will fail you eventually but keep rubbing that taliman and hope it’s magic will rub off on you if it helps you sleep at night.
“My mothers generation used to judge based on the school you went to and this one it’s based on the food you eat.”
I just want to thumbs up this statement a bunch of times. The majority of the judgement I personally see as a mom is about food.
Oh this is entertaining. I am quite happy, thank you very much, with the options afforded my kids. We have it good here in the USA, with regulated, safe formula and clean water. We do not need your activism. My son’s formula (enfamil infant) ingredients are: nonfat milk, lactose, vegetable oil (palm olein, coconut, soy and high oleic sunflower oils), whey protein concentrate, polydextrose (a prebiotic), galactooligosaccharrides (aprebiotic), DHA, AHA, and various vitamins.
All infant formulas have some form of added sugar in order to keep the proportion of fat to protein to sugar appropriate for the infant’s metabolism. Regular formulas use lactose. Sensitive formulas use corn syrup (like Karo, which is not that sweet, not the high fructose kind). Sucrose is the principal sugar in most organic brands.
What we eat does impact our intestinal flora but no one knows yet what that means or what impact it has on our future lives.
“Junk food for infants”
Ha! It must be a miracle then that my formula fed baby weighed just 16 pounds at 1 year of age. However did she manage not to be obese when I was giving her such toxins? Nevermind that she weighed just 7 pounds at 4 months while being exclusively breastfed. Shoulda stuck with it.
What ingredients, specifically, would you not give your older children?
BPA (found in can lining), refined processed oils, soy, synthetic vitamins and minerals (for example, I would strongly prefer folate as opposed to folic acid whenever possible). Unfortunately the so called “sensitive” and hypoallergenic formulas do usually contain corn syrup and other forms of processed sugar I would prefer to limit.
Oh sweetie. There’s BPA in your breast milk, too.
Could you explain why synthetic vitamins are bad?
It contains sugar because human babies need lots of sugar. Cow’s milk doesn’t have enough sugar for us.
Sweetie? You must be a nurse (ugh). Only those annoying knows just enough to be dangerous nursey types use words such as “sweetie”…but I digress..
Anyway, I am aware of this. However, BPA has a short half life. As I don’t consume canned foods, use plastic piping (and reverse osmosis filter-although mainlines may not be BPA free), nor use plastics or keep receipts, my exposure is probably lower than most.
Sugar, as provided through corn syrup, is NOT a required macronutrient.
P.S. Normally I would have been nicer in my post but you deserved exactly what I wrote…
Sugar is not a required macronutrient. You actually said that.
Get off my Internet. Seriously.
What the hell does she think the body runs off of?
Smugness
We haven’t found you particularly nice so far, but good job doubling down with that “nurse (ugh)”. Very efficient.
I remained on topic and respectful until posts became ad hominem attacks simply because I mentioned formula and gut flora. Thanks…I try.
Do you want an effing TIMELINE of your behavior here? Shall I start with the moment you took someone to task for using the word “malarkey” or shall we give you one for free and wait until the point where you suggested I should have less emotional reactions to your suggestion that I should have passed up the opportunity to use a simple, safe treatment for my son’s newborn jaundice?
For the record, your ideology is wrong, but you’ve been a stone bitch.
Sarah “I remained on topic and respectful”
Elizabeth A “Do you want an effing TIMELINE of your behavior here?”
That timeline includes Sarah declining to post links to her sources yesterday evening because she claimed new mom status and in two separate posts declared herself “too lazy.”
How respectful is it, Sarah, to initiate a conversation and then tell those with whom you are conversing that we are not worth your effort?
I will thank you for finally posting links to some studies today, even if they were just the PubMed abstracts.
But I will also ask you to open your own mind and recognize your own limitations. And perhaps learn some more about biochemistry, as you continue to “share information.”
Sarah “Only those annoying knows just enough to be dangerous nursey types”
Pot, meet kettle.
And, no, I’m not suggesting you are a nurse.
Nutrition FAIL.
Would you rather be called rude, obnoxious troll? I’m sure that can be arranged. Those “annoying knows just enough to be dangerous nursey types” know a lot more than you can ever hope to know. The next time you need to make a trip to the ER, pull that nasty, superior attitude and not only will you get the disrespect you deserve, but you won’t get the drama and attention you think you deserve.
If sugar is not a required micronutrient, why is it in breast milk?
I’m a stay at home mom with a bachelor’s degree in a totally unrelated subject.
I just prefer to listen to the experts when it comes to Teh Science.
You just had a baby, right? How long have you been concerned with avoiding BPA to this level? I am saying this in a BTDT way. Please get screened for anxiety/ocd.
Sarah “I would strongly prefer folate as opposed to folic acid whenever possible”
Why? Do you know what the difference between the two is? Can you explain it in your own words?
Use your big girl words, Sarah!
Cause wellnessmama.com says folic acid supplements lead to certain cancers. And if it’s on the internet, it MUST be true!
What is the difference, at a molecular level, between a synthetic vitamin and its ‘natural analog? If I gave you a sample of synthetic Vitamin C, for example, in one vial, and purified Vitamin C in another vial, how would you tell them apart?
The GMOs, duh.
I am not a big fan of sugar for my kids, but if I had a child who had dietary sensitivities that severely limited his or her food options, I would not hesitate to load the kid up with whatever s/he could eat. When alternatives are limited, you have to reevaluate your standards.
Generally speaking, if you eat whole unprocessed foods (avoiding allergen x specific to your case) than you can do both. However if consuming a lot of processed items, it most certainly would be difficult. In the case of formula, I do think there are better ingredient options that should be used, as stated previously, but they are more expensive, which ups production cost and cost to the consumer.
…which specifically disadvantages low income and/or working moms who rely on formula to feed their kids when they’re not around. We don’t need this stuff to get more expensive.
But we’re talking about feeding infants, so the standard suggestion to shop the edges of the grocery store is not helpful.
It’s nice, I guess, that you’ve acknowledged that formula cost is one reason to stick with cheap ingredients. You haven’t addressed the concerns about the suitability of the ingredients you prefer. Shelf-stability? Allergens? Consistency at room temperature?
EtOH has been tried as a concentrated calorie source for micro preemies. Standards reevaluated indeed.
Also, you know that many formula companies have voluntarily gone to BPA-free packaging, yes? Sometimes your statements sound like you read “So That’s What They’re For!” and think nothing ever changes.
Unfortunately, this is what they SAY, but there is still BPA in the packaging.
When studied (pull up Health Canada link), all mainstream brands did contain BPA. However, to be fair, I am not sure if the study was conducted prior to the transition to “BPA free” cans or not.
If one was able to get their hands on recent unbiased data (I.e. outside review) that clearly shows there is NO BPA at all in the product, that would be reassuring,
Current statements by formula companies state that “no BPA is found in our products when we tested for it”. They are unclear as to if some components of their cans do in fact use BPA.
Oh, this is beautiful. You think that someone maybe once, on Health Canada someplace, determined that formula packaging (which are the non-mainstream brands, btw?) contained BPA. Maybe this was before they switched to BPA-free packaging. You’re not sure. But you totally believe that the packaging still contains BPA.
You might believe it if an outside review did the impossible and proved a negative.
As stated, I’m not making any effort for you clowns (my apologies to the posters who have actually wanted to discuss the flora colonization topic at hand intelligently). Yes, a Health Canada page clearly lists the major formula brands and their BPA levels.
An example of a “non-mainstream” formula would be Earth’s Best or Neocate.
If someone without a vested interest in the product (I.e. the formula manufacturer) did some recent testing, I would prefer to look at those results over the company’s internal testing, which was not verified. Do you not care if formula is BPA free? I guess not. But why am I the bad guy here?
Did I make a rude comment? Yes. But only after I was called an asshole, a breastfeeding Nazi, etc. All for trying to discuss the topic of this blog, which is not my blog, and I did not start it.
And I stand by my comments. The goon posting (not you) clearly upset by my nursey comment is exactly why I WON’T get admitted as a patient to any ER. Unless I’m dead, in which case incompetent nursing staff can only improve my situation. A little bit of education, and one huge chip on their shoulder=90% of this group of healthcare workers. I am DONE on the formula issue. If you are a-ok with current formula and research on formula, then stop replying to my posts. Please.
You hate hospitals and doctors so much that if you were deathly ill you would refuse going to a hospital? And you want us to take anything you say seriously?
Please tell me that if your CHILD was sick you’d seek medical care for him and get over your ridiculous pride.
Ahh, struck a nerve! Folks like you really hate to have the truth pointed out to them. Just remember how your words taste. You might have to eat them if your life gets saved by some “incompetent” nurse someday. Although, hopefully you’ll stand by your word and stay away from mainstream healthcare. You’ll be doing us all a great favor.
Sarah, the only reason you’re getting rude comments is that you stormed into this blog determined to “educate” us on a topic about which most of us are quite knowledgeable. You got huffy when your assertions were refuted one by one, you got frustrated when we weren’t taken in by the tropes we’ve heard a thousand times before. Hell, I *work in tissue typing* and you tried to educate me about the HLA types associated with disease, telling me my knowledge was outdated.
You made ridiculous (YES, ridiculous) assertions like “one dose of formula will increase your child’s risk of autoimmune disease!!!1!” and you implied that another poster’s 7 year old child might still have yet to show the lingering effects of the ebil formula. You implied that those of us who fed formula didn’t care enough or were too lazy to “do our research.” You claimed knowledge, then claimed you were too busy to answer our questions. You questioned the wisdom of treating neonatal jaundice with formula, although numerous neonatal practitioners assured you that it was standard practice and has been for quite some time.
And yet, we are the rude ones?
http://www.ncbi.nlm.nih.gov/pubmed/23212895
“Total BPA was detected in 93 % of this healthy infant population aged 3-15 months who are without known environmental exposure to BPA. Neither free nor total BPA urinary concentrations differed significantly by infant’s sex or by nutritional source (breast milk and/or formula) while age group was of borderline significance.”
http://www.ncbi.nlm.nih.gov/pubmed/24709781 BPA present in urine before birth.
You’re never going to let soy cross your precious snowflake’s lips? Good luck with that.
Hahaha. I have a severe soy allergy, and even I can’t avoid it entirely (and I try really, really hard).
I have a mental list of dumb stuff I believed when my first child was tiny. I never went as far as believing that we could entirely avoid the ER (maybe if he hadn’t had formula, he’d never have taken a tumble off a play structure), but some of my thinking was at least as dumb as thinking we could avoid soy entirely.
“Some of my thinking was…thinking we could avoid soy entirely.” You don’t realize how hard it is to do until you try. Until I tried to cut it out of my diet, I had no idea that it was basically in every single processed food in the grocery store. I just didn’t know.
There is no difference between corn syrup and any other type of sugar for people with no intolerance to fructose. The only real problem is it is so cheap here that they put it in everything so if you buy a lot of packaged foods or don’t have much money to spend on food you end up getting way too much sugar in your diet. Also, high fructose corn syrup is chemically identical to honey. Your body has no idea it was processed.
Our understanding of gut flora is still in the preliminary stages. People who are dedicating their lives to understanding how gut flora effects health can’t make any certain claims. People who are dedicating their lives to diabetes research can’t identify a certain cause for type 1 diabetes. Yet here you are with the certainty of the ignorant claiming that formula has a negative impact on flora and that causes diabetes.
I have always wanting to see a Nobel Prize Sarah. Can you show me yours? You know for your groundbreaking discovery on the effect of gut flora on the immune system and the cause of two separate disease (type 1 and type 2 diabetes). Oh wait, you don’t have one you are just some lady on the Internet making claims you can’t substantiate based on research you don’t understand? Bummer.
I don’t see how your statement helps this discussion. It is very ad hominem and out of place.
Gut flora is showing that it may very well play a role in MANY disease processes, yes this includes everything from autoimmunity (including T1DM) as well as insulin resistance and obesity (T2DM).
Please review the links I have posted below in a previous reply (abstract only, my apologies), it may help answer some of your questions, or at least understand that what I say is in fact, nothing radical in the slightest.
I will ignore your unprofessional conduct.
If I have time, I may repost specifically to you.
Radical ideas, no. Radically misunderstood and misinterpreted, yes.
And I will restate that the research on gut flora is still in its preliminary stages and it would be grossly irresponsible to either reduce the restriction on milk donors, to give milk that is meant for premature babies to full term healthy babies, or to let babies starve while their mother waits hopes and prays for her milk to come in based on preliminary research. We do not know enough about gut flora on health to make any recommendations.
A couple decades ago, there was some preliminary research that suggested that the MMR vaccine causes autism. Thousands of parents stopped vaccinating their children as a response. Now we have diseases that we haven’t seen in decades making a comeback. We now know that at least one of those studies was fraudulent and nobody was able to replicate the results. But at the time, nobody knew that and a lot of parents made a rash decision based on research that was preliminary. Let’s not let history repeat itself.
Science takes time. It takes time to replicate studies, go through the peer review process, account for confounding factors, etc. Unfortunately, people are impatient and will avoid things “just in case” before science has finished sussing out the truth. Few people realize that avoiding something “just in case” can cause just as much problems continuing on as normal while scientists try to figure out the truth if not more.
I will add that it is irresponsible to talk about the role of the microbe on diseases like diabetes as if it is settled fact when the truth is that the research is still pending. That is far more “unprofessional” than me being rude to you.
Actually, type I diabetes is associated with genetic predisposition, specifically it is common with certain tissue types (which makes sense, as it is an autoimmune disorder), and also certain ethnicities, and is highly heritable. It is also influenced by some as yet unknown environmental factors (some speculate a susceptibility to certain viruses such as coxsackie, others implicate exposure to certain very specific chemicals, most certainly not included in baby formula) . Your tissue type, parentage, ethnicity, susceptibility to virus etc. does not CHANGE based on whether you were breastfed or formula fed.
And “it is accepted that there are most certainly long term health risks to formula feeding…” accepted by who, exactly?
Actually, this is not an updated view. In fact, while T1DM is known to be associated with certain “high risk” HLA types (HLA DQ2/DR3 and HLA DQ8/DR4 are two that come to mind) as well as other genetic markers (some known, likely some not), the fact remains that this is NOT strictly a genetic disease. Identical twin concordance is only in the range of 30-50% based on the studies I have seen. I will exclude monogenic autoimmune polyglandular syndromes (I.e. AIRE mutations) which may (rarely) have T1DM as a component as it’s unclear if HLA types and other genes influence T1DM onset in those patients.
Additionally, it is now recognized that previously LOW risk genotypes are now developing the disease (an area of current study).
So it’s highly likely that environmental factors are playing a role.
And ironically, most certainly formula/lack of breastfeeding has been implicated in the pathogenesis of T1DM, at least for a certain subtype of this population. Likely T1DM, like other autoimmune diseases, remains a mystery due to the fact that the trigger(s) for these diseases may be different based on one’s geneotype.
http://www.ncbi.nlm.nih.gov/pubmed/24746688
http://www.ncbi.nlm.nih.gov/pubmed/24444005
http://www.ncbi.nlm.nih.gov/pubmed/24140380
http://www.ncbi.nlm.nih.gov/pubmed/22946851
Is the research 100% conclusive? Of course not. But there is enough there I would think for intelligent discussion of the facts that are known.
You don’t know what anything you just wrote means.
Copy-paste. Copy-paste. (Repeat)
It’s a bit painfully obvious. And I do mean painful.
Here’s how you do it. Post ONE link. Make an effort to find the full text, if it is available. Quote or paraphrase the part that supports your claim.
I did not say it was strictly a genetic disease. I said genetic and environmental factors are in play; those environmental factors are NOT known for sure and it’s completely irresponsible to imply that formula feeding is to blame. And yes I’m aware of the twin studies. You know, twins are likely to have been fed the same diet from infancy onward…pretty fishy that you’d have a pair of identical twins where one developed IDDM1 and the other didn’t. Since, you know, feeding is so important and all.
If ONLY there was a study out there that compared siblings within the same household who were fed differently, one by breast and one by formula. Then we could really talk about long term effects of infant feeding. Oh wait.
1. First study is the same dude with his mice that you mentioned above. One guy and some mice might be a good enough basis to give a subject further study, but it is not a good enough reason to change evidence-based medical practice.
2. I couldn’t find the specific study you cited, but I found plenty of others by the same authors based on results from the same study. A lot of their work seems to be about food intolerances, not about duration of breastfeeding. And if you go only by the abstract (which I’m assuming you did because the article itself doesn’t seem readily available), there is no mention of breastfeeding vs. formula at all. It’s talking purely about cow’s milk consumption.
3. Ah yes, the non-systematic review from Brazil (I found the English translation, did you?) which is so non-systematic that they don’t tell you what their inclusion or exclusion criteria were. And despite trying desperately hard through the entire article to draw the conclusions they so obviously want, they are forced to conclude with the observation that there is “still no consensus in the scientific community” about whether breastfeeding is a possible modifiable risk factor for diabetes. They are also forced to note in their conclusion that methodological issues make it almost impossible for any study to determine this definitively.
4. Now this, on the face of it, is a good systematic review with clear a priori inclusion criteria. However, it concludes “Although there is some evidence to suggest that breastfeeding is associated with a reduced risk of T1D, this evidence must be interpreted with caution because of the possibility of recall bias or evaluator bias and inadequate methodological quality, including sample size, and suboptimal adjustments for potential confounders in the primary studies.” So again, an area that may be worthy of further study but certainly not conclusive enough to change evidence based practice – and certainly not conclusive enough to be telling strangers on the internet that with one dose of formula they’ve ruined their kid’s health forever.
You’re over-reaching, Sarah. Big time.
Our formula options are great, thank you very much. My baby was wasting away on my breastmilk and thrived on formula. I am very thankful for formula.
Have YOU read any of the articles of which you speak? ALL of the article? Or just the abstract?
Who accepts in what studies in what population, conducted by what team, are long-term (it’s hyphenated by the way, it’s a pre-modifying compound adjective, I mean, not that it matters) risks associated with formula feeding?
Please share the results with us riiiiiight herrrs.
“The risk here is largely due to intact cow’s milk protein”
Or maybe it isn’t?
http://www.ncbi.nlm.nih.gov/pubmed/24915259
I’ve been listening to older women who raised babies in the 50’s and 60’s tell me about how horrible the formula was. Fat-free dried milk is what they had around here.
We’ve come a looong way in the quality of infant formula.
You know what? I was a milk bank donor, and I really resent people with healthy full term babies selfishly obtaining that milk because of superstition about epigenetics. I pumped that milk for micropreemies. Maybe you are from an alternate universe where donor milk flows like tap water, but there are preemies getting NEC here in realityland, and your full term baby did not need donor milk as badly as they did. Or at all.
Actually, after reading her smug reply to Elizabeth A., how Elizabeth’s son was only 7 and there was still time for the poisonous effect of the formula he once had to show, I think her baby needed your milk, formula, anything BUT her breastmilk. Every ounce of cruelty, selfishness, and smugness less would make her child a better person than she is.
I wonder if that’s how she’ll speak to the other second graders’ moms at the bus stop.
“Little Johnny’s not reading yet, eh? Too bad he had that ONE bottle of formula at the hospital…”
I am a second grade mom too and all the none of the moms talk to me the way she has. Sheesh
Wish I could upvote this comment x 1000!!
Can-I get-an-amen.
As a NICU nurse, NEC still remains the only thing that truly terrifies me. It can strike with no warning, and kill within hours. It’s a freaking nightmare.
I hope someday they’re able to replicate what breastmilk does to prevent NEC, or identify which people produce the best milk for it.
Me too, because from my experience, there just seems to be no rhyme or reason to it quite yet. Which is what makes it terrifying. You are amazing for donating milk…so happy your helping those little peeps I love (and we all love) so much!!!
Oh, I’ve been done for a long time, now! I sent about 500 oz, I hope mine was the good stuff and it helped someone out!
http://www.ncbi.nlm.nih.gov/pubmed/22138535
http://www.ncbi.nlm.nih.gov/pubmed/24919691
Yes my infant was full term, but never ONCE did you ask me WHY my son needed it.
Perhaps it’s time to reexamine why people mistakenly assume ONLY prems need the only source of nurtrition an infant requires for the first 6 months of its life.
That being said, thank you for being a milk donor. It is truly an amazing gift and I hope many more will share this gift for ALL babies who cannot get breastmilk.
Okay, sure, I’ll bite. Why did your full term infant need donor milk?
This will be a good one.
There are a very few rare disorders in full term babies that donor milk can benefit. But if her snowflake had one of them, she’d have mentioned it by now.
I’m 99% certain it’s a Dr. Google disease that sent her to the Craigslist milkbank.
Given the fact that Snowflake wasn’t prescribed milk from the best source – banked donor milk, – I’d guess that his condition was grave enough to warrant donor milk only in his mother’s head. Of course, as we saw, there isn’t such a thing that isn’t grave enough to warrant donor milk in her head. After all, she’s informed and she’s deigned to come here to enlighten us.
Because you know, no one here was EVER interested to read about the subject before Sarah blessed the world by bringing Snowflake earthside and decided to share her well of knowledge with stupid who only have what? 10 years or so more experience than her.
She got all pissy that no one asked why she used banked milk and STILL hasn’t answered.
Please, do tell us the specific diagnosis provided by your son’s pediatrician that mandated banked milk that could have gone to preemies instead and specifically why the pediatrician felt that formula would be insufficient.
Sarah? Sarah?
*crickets*
And you are so full of it. Until there is an overflowing supply of donor breast milk, which we all know there is NOT, preemies SHOULD be the ONLY babies who get it. And unless you can come up with a really compelling reason why a full-term baby would need breast milk over the needs of a preemie, (which we all know you can’t), you need to stick with topics you actually know something about.
Sigh. I’m going to join the pile-on because you’ve made several wildly incorrect statements throughout your conversation with us.
1. Properly screened banked donor milk is not widely available and is generally reserved for the sickest preemies. Hospitals in my Canadian city get their donor milk from Ohio because we do not have the infrastructure in place to produce it ourselves. Whether or not we should, is an entirely different debate (and I would argue that we should).
2. Infant formula is the most highly regulated and controlled food product on the planet. If you purchase infant formula in a developed country you can be assured that it has been screened and scrutinized to the nth degree. The ingredients must adhere to the Codex standard for infant formula, and any additional ingredients not *specifically* allowed for in the Codex must have scientific evidence supporting the benefit to the infant before it can be added. Developed countries have regulatory oversight of this process, so if you see a can of formula in a store, you can rest assured that every ingredient has been scrutinized – from ensuring adherence to the Codex standard, to ensuring that the entire supply chain meets safety requirements.
3. You have managed to name one formula that lists corn syrup as a first ingredient. This was a formula for infants allergic to cow’s milk. Stop it with the HFCS scare tactic.
4. The single most dangerous ingredient in formula is the water used to hydrate it. Why? Because that’s where the manufacturer has no control. In most parts of the developed world, the water supply is safe and this is not a concern. This is also why breastfeeding should be more strongly encouraged in the developing world; mothers don’t have access to a safe and reliable water source.
So, with that all in mind, my questions to you would be: which aspects of the Codex standard on infant formula require strengthening and which measures would you recommend for improving the safety and quality of infant formula? What measures should we undertake to improve the availability of properly screened donor breast milk? Because if you can’t answer those two questions, I don’t see any point in discussing the relative merits of infant feeding methods any further.
So instead of working to FIX the system so as many infants as possible CAN get donor breast milk (and as MOST mothers CAN breastfeed this is a minority issue), you have decided to support why you THINK formula is a fine product when breast milk is superior. I fail to see the logic.
There are MANY such ingredients that one must question, including DHA processed with hexane (unsubstantiated to have the same effect as DHA in breast milk), soy isolate, as well as those formulations which do in fact use highly processed forms of sugar. Those which do not (I.e. the “regular” formulas) typically contain largely intact foreign food proteins (soy, cow’s milk), which probably is not best given to a young infant with a permeable gut. And let’s not forget the missing immune components of breast milk.
But here, I go, replying to a topic I never originally cared about (briefly mentioned in my first post, and every formula feeder in the world came out to comment).
Milk banks can be established, if interest and need is shown by the community. In fact, they used to be common place. It wasn’t until recently that the health of formula fed infants (essentially most of my generation) was looked at again did breast feeding once again become looked at. However, most of those milk banks are long gone. Work is ongoing in many communities to restablish those banks. Calgary is one of the newest.
Okay, really? WHEN were milk banks commonplace, and where?
I also have issues with the “most women can breastfeed” theory. Yes, it is undoubtedly physically possible for the majority of women to produce breast milk, but physical ability to accomplish a task is never the only factor.
How many women WANT to exclusively breast feed until they introduce solids? How many women find that it’s easier to earn a living if they aren’t taking pumping breaks? How many families find their day to day lives easier to manage if they use formula?
I don’t think it’s possible to meaningfully advocate for families without acknowledging people to be experts in their own situations, and respecting the decisions they make about how to handle the challenges they face. I absolutely think we should improve a large number of social structures, but maybe we could start by not making assumptions about what is best for everybody.
How many women are able to feed a baby realistically. Those who aren’t on medication, those who don’t have issues (eg some immune system issues, some hormonal issues, some mental health issues, some chronic pain issues, some breast issues) and those who have enough support – financial, mental and physical.. Honestly it’s much easier for breastfeeding advocates to berate women to the nth degree than to actually fix the actual issues that allow for real choice. And even then they might not increase breastfeeding rates, because that is STILL up to individual mothers as to how they choose to use their bodies.
“Most women can breastfeed” is another lie women are told by breastfeeding advocates and is generally used to shame women that are having trouble.
“Most,” yes, for most defined as more than 50%. The problem is that they imply “almost all,” which is NOT true at all. And then fail to apply conditional probability to the pool of women having difficulty with breastfeeding, supposedly uncommon problems will occur more often in that group.
“Epigenetics is a hot topic right now”
Can you explain, in your own words, what epigentics means, its mechanism, and its degree of plasticity?
Ugh.. I hate it when people say “Studies say…” or “doctors say…” without citing the studies or doctors. If there are solo many studies why dont’t you cite one, explain what you think it says and why it supports your opinion. Otherwise, I am going to assume you are like most people who cite “studies” and are talking out of your ass.
OT is this site crashing a lot for anyone else? It must have crash 10 times for me last night.
What is your take on the Belarus PROBIT study that shows that overweight/obesity was *increased* in the infants randomized to the breastfeeding intervention group? And that the effect can still be seen in school age children? What about the discordant sib studies that show *increased* asthma in breastfed infants?
I will most definitely review the study, I am not familiar with that paper. Possibly due to specific chemical exposure in the mothers (I.e. BPA) which is expressed in their breast milk? However, I’m not really interested, as the topic we’re discussing is mode of delivery and gut flora.
Here’s the link for your, Sarah:
http://jama.jamanetwork.com/article.aspx?articleid=1667089
I’ll be looking for your take on it tomorrow, to give you a chance to read and think about it.
“Breast milk is magic. So if exclusive breastfeeding did not have a positive effect on an outcome over formula, or perhaps a slightly negative effect, I will hypothesize some sort of contamination of the mothers’ precious bodily fluids, without any evidence at all.”
I may come to regret asking, but exactly how would a mother (or a healthy medically screened donor) ‘colonise’ an infant with vaginal flora?
Better test all those mothers for GBS first. Just saying.
I always find it concerning how people are so easily lead up the garden path. I think this article makes a great point of how, in the face if no or strongly opposing evidence, that groups of people still desperately try to find that back door to legitimize their actions or ideals.
Im a flight instructor by profession and knowing the inexperienced from the experienced is now quite an easy task for me. Ive had my fair share of 18 year old “experts” with countless hours of flight sim x experience jump in the plane and act like they should already be flying A380s across the Atlantic. This is usually the time I turn the engine off and remind them that I’m the one with the experience and unless they are prepared to listen learn and be trained, then they can get out of my plane before they kill us both. Amazingly many have come back and thanked me for that somewhat blunt appraisal, admitting I was right and that they realise now they knew very little about flying a plane.
So I can only imagine what actual scientists think when something like this pops up and misleads so many.
There’s a free screening in Houston this Saturday.
http://www.houbirth.info/index.php?option=com_content&view=article&id=64&Itemid=80
According to a radio program on last night promoting the
event, you can also edumacate yourself on vaccines, placentophagy, homeopathy, homebirth, VBACs, unschooling and Waldorf education.
I am tempted to go but one of the coordinators is someone I used to work with and I don’t think I could look her in the face knowing she believes in all that stuff. It all sounds so benign and plausible and harmless on the surface if you don’t know any better. But so much potential for catastrophe.
In light of the research – by real microbiologists – showing that people and their pets have multiple shared strains of bacteria in common, a shared household microbial population, its reasonable to assume that baby’s “micro-herd” will come to resemble Mom, Dad, Brother Timmy, Sister Meghan, and Fido and Fluffy with no effort on anyone’s part.
If you’ve ever seen what it takes to produce and maintain SPF (specific pathogen-free) lab animals the idea that it takes special effort and immediate action to colonize the baby’s GI tract is ludicrous.
This is what I was thinking. How long do they imagine babies are routinely being sequestered in a sterile environment for this to be such a revolutionary and urgent issue?
Yeah, am just going thru an article on the placental microbiome (med school assignent) and it refers to other work which states the infant gut takes a week to colonise (and I think 2yrs to be stable?) and there is not as much lactobacillus as you’d think (I.e from passing through a vagina colonised with lots of lactobacilli)
OT: if you haven’t already, take a look at the “Things Anti vaxers say” Facebook page. I found it quite by accident and I have been howling reading stuff there all night.
Oh myyyy! Some of the things about Ebola are just…wow. I went to look for the list of things Philip Day had said about Ebola. No surprises, but it’s disappeared and now the “Vitamin C cures it!” thing has taken it’s place. (It used to be vitamin D deficiency and malnutrition that he was blaming for people contracting it. Should have grabbed a screenshot!)
Apparently pineapple juice should be “taken for boosting the immune system”. One woman was saying we have “sanitation, nutrition and alternative healthcare” for when we get sick. Her privilege was showing, also her ignorance.
vitamin D deficiency
Vitamin D deficiency? But…equatorial Africa, sun…never mind.
I wish I could laugh, but I’m just bewildered. As in…”Please, PLEASE tell me people aren’t stupid enough to actually believe this shit!” you see, I’m a Social Worker, and I work as part of an organ transplant program, with people who are on powerful anti-rejection drugs that suppress their immune systems. These anti-vaxers put my clients at risk, every one of them. I’ll be damned if it isn’t at least somewhat personal.
It is horrifying what these people believe. Also how they spell.
I have an 8 month old and I dread turning down play dates because of the unvaccinated kids who will be there. My husband’s aunt had polio as child, she struggles with post polio syndrome now. She hates anti vaxers with a passion, as she says they are “volunteering their children to test out the theory that measles or whooping cough aren’t so bad”.
Unbelievable stuff that’s for sure!
So what if the mom is not healthy. According to these people, the biome exerts huge influence…and following that logic, mom probably has a shitty biome if she is not healthy herself (sorry, couldn’t resist). Biomes are being blamed for obesity, auto immune disease, diabetes and so on… so it would follow that if the mom had any of these health issues, she should sign up for a c-s so her baby can avoid her sub par biome. We could have biome sharers- maybe the doulas will offer that as part of their service. You could be a vaginal biome donator to help save the human race!!! (Sorry, its late and I’m getting obnoxious).
Exactly. You see this approach from NCB/BF’ers on many (if not all) topics. They interpret flimsy data in a way that best supports their agenda.
Cortisol levels in infants is another example. The Dr. Sears’olytes have used Cortisol (elevated) levels as the scientific ‘proof’ to support attachment parenting for years. As new data emerges about the effects of maternal cortisol levels on breastfeeding infants, I expect that some serious spin is incoming.
Actually scratch that, they’ve already started:
http://thepaleomama.com/2014/02/breastfeeding-results-are-not-exaggerated/
Reference #28 in that article, doesn’t really support anything, it’s just a hypothesis. %40 higher levels in breastfeeding infants could actually indicate a real downside to breastfeeding. It could support a hypothesis that stressed out breastfeeding moms can adversely affect the emotional development of their children.
http://www.bbc.co.uk/news/education-29237874
This study is being touted as the new big thing, when all it does is re-state something we already know- adequate maternal thyroid function is required for optimal foetal brain development.
I’m slightly amused by the fact that she claims “13 studies,” then makes 13 statements supported by a total of 28 references, some of which are studies and some of which are not. The first reference is AAP’s official statement that breastfeeding is recommended.
I am seriously NOT surprised at the idea of “biome” doula who would donate her “clean eating and unvaxxed” vag secretions for new mums to wipe on their babies. ugh.
But what’s supposed to be so special about the flora in the vagina in particular? I don’t get that. Babies don’t get enough flora from amniotic fluid and through the umbilical cord? And there’s nothing at all in the outside world that comes even close to what you get during a vaginal delivery? I’d love to know why all that good-for-you flora has decided to reside in the vagina. What purpose does it serve other than seeding the gut of the couple of babies who will at some point pass through there? I mean, I know there are magical unicorns and fairies living in every woman’s vagina but what is all that stuff that’s supposed to be protecting her digestive system doing down there?
If you want a serious answer, normal flora in the vagina is for producing lactic acid and holding down pathogens, mostly. Like how antibiotics cause yeast infections?
And here’s where it gets really interesting. We used to think the placenta and everything was sterile until membranes ruptured. It isn’t. The placenta definitely has bacteria all through it, and there may be an association between their type and number and all sorts of pregnancy complications, including preterm labor.
And yeah, actual studies show that c-section babies are a bit less “seeded” at birth, but the difference starts to fade within days, and once they start solids, there’s no meaningful difference.
Thanks, that’s a very clear explanation. Though, I’m still fairly sure there’s some unicorns and fairies at work in there somewhere.
Yes, the placental microbiome most closely resembles that of oral flora, not the gut or vagina. Peridontal disease is associated with preterm labour, as is bacterial vaginosis. Lots of inflammatory and/or infective aetiologies of preterm labour, amongst others.
I saw this almost a couple weeks ago and I’m just going to post it now before I forget. All I could think was “Oh my god, the shitty midwives are going to tell women to take low-dose aspirin and insinuate or outright tell them that they won’t get preeclampsia.”
http://www.pharmacist.com/uspstf-finds-daily-low-dose-aspirin-could-prevent-preeclampsia-risk
I wouldn’t worry abut it. Aspirin is a pill not made by quacks. It’s safe to say they will see it as bad for you. Regardless.
The clever ones will tell moms to eat the herb or drink a tincture of whatever that plant is that aspirin was made from.
Willow, it is made from willow.
Drinking willow bark tea is not a good idea unless you know exactly what you are doing.
Don’t make willow bark tea from a tree in your garden, don’t give it to children and don’t do it just because you think it is more “natural” than aspirin.
Beethoven possibly died from willow poisoning because he took a lot of it.
I went to a lecture on the microbiome about a year ago. I learned that both modeling and empirical data seemed to suggest that inputs matter, but the researcher said there was little support for the notion that any given “seeding” retained disproportionate influence over the outcome. In fact, outcomes seemed to be pretty stable over time. But this is definitely not my area. Anyone?
Which microbiome did it focus on?
It was a theory and data talk, and covered microbiome data from a variety of taxa, including humans.
Can’t they just look at the long term health of people born by c-section and compare that to the long term health of people born vaginally and then put the whole issue to rest? I know it’s really difficult to correct for confounding factors in a study like that but if we’re really talking about “the future of mankind” shouldn’t we be seeing some really profoundly alarming differences between the two? Like, people born by c-section die from norovirus 27 times more often than people born vaginally, or something like that? If the future of mankind is at stake, I would think there would be some really obvious evidence of the long term health effects of c-sections, since they’re not exactly a new thing.
If we went on an anecdotes, like the NCB crowd, then I could raise my hand and say: “Well, I was born by caesarean! I have IBS-symptoms and caught tummy bugs regularly as a child, and I wouldn’t have that if I wasn’t a caesarean delivery*!” (*because I’d be dead)
Of course, that’s completely ignoring that there seems to be a digestive system component to my joint disorder and that my mother may have Münchhausen’s by Proxy, but those things don’t matter when it comes to pushing an agenda.
I am quite sure that, if not for my c-section, I would never have developed breast cancer.
I’d have died in childbirth two years before diagnosis. But see, no breast cancer!
Even if there is a long term difference between the two groups, who cares? Without a c-section there won’t be a long-term to worry about.
Sadly, all the people pushing this nonsense don’t seem to think so. To them, every Caesarian is an unneccaesarian. Of course, with that kind of thinking I suppose that even a couple of dozen studies wouldn’t convince them that there’s no difference between the two. It certainly didn’t convince any of the anti vax crowd …
It’s difficult to correct for confounding factors unless you take a group of pregnant women and randomly assign them to elective C-section or vaginal birth. Even then, you’d have to toss from the study emergent C-sections. The reasons for the C-sections could be the reasons behind the poor health outcomes.
A study showing higher IQ or greater developmental achievement in people born by Caesarean would set the cat amongst the pigeons! Save those brain cells!
I wish there was a way to hate-watch this movie without giving the creators any money.
There probably will be (if there isn’t already). I’m not usually a big piracy fan, but in this case…
It should end up on Netflix eventually.
The biggest moron of them all just posted this gem:
“Pregnant People: I’m begging you – do not be afraid to switch providers if you realize at any point that your doctor or hospital doesn’t offer or doesn’t specialize in what you want out of this birth. You don’t owe them anything. You’re a consumer: shop around. And don’t think, “Well, I’ll just pick someone different for the next pregnancy.” Because what happens in this birth can have a huge impact on your choices for the next one. If you have a cesarean-happy OB and end up with an unnecessary cesarean, it may be hard to find a provider who will do a vaginal birth next time. PLEASE, SWITCH NOW if you aren’t getting what you want! The hassle is worth it!”
Hint, she alleges to have $120,000 in student loans from getting a degree in public health yet can’t get a job as a cashier. just can’t with this anymore.
Uuuurgh. There are differences between buying a pair of shoes and giving birth. If you made a mistake with the shoes you can give them back. If you “shop around” and find a horrid provider PEOPLE DIE OR ARE DAMAGED.
Stupid people.
Eh, I agree with her on this one. I had to switch OBs when I was 28 weeks pregnant, not because of NCB or fear of CS but because my provider was behaving unprofessionally and I finally reached the breaking point. I was so much happier with my second OB even with the late switch. So yeah, if you’re not happy with your OB don’t feel like you’re stuck with that person to the end of your pregnancy.
But that has nothing to do with the situation. Imploring women to change providers because they won’t allow a certain and potentially dangerous birth is completely different than dealing with a provider that you deem unprofessional for other reasons.
It’s like choosing a restaurant based on the variety of food it serves vs one that has known issues with the health department.
Although when it comes to restaurants, both are perfectly acceptable approaches, there is clearly a fundamental difference between them.
I suppose it’s more like ‘firing’ a restaurant that won’t agree to serve you unpasteurized milk?
I am strangely reminded of the Simpsons episode where Homer insists on having fugu (a type of fish that requires a lot of skill to prepare, or it can be poisonous) at a sushi restaurant, even though the chef who actually knows how to prepare it isn’t available. He pounded on the table and pressured the restaurant to serve it to him, even though they weren’t equipped to serve it.
She wasn’t talking about changing providers due to unprofessional behavior. She was telling women to change providers if they aren’t getting “what they want”. She is encouraging women to value having a provider who doesn’t discuss risks and will not condone a birth plan that includes potentially killing or seriously injuring the baby in the process.
Earth to Gina: Most of us privilege a living child over a vaginal birth. Most of us do not get pregnant to have a “birth experience;” we get pregnant because we want to raise children to adulthood. While I will always remember the days that my children were born, my prevailing sentiment regarding their births is that we both survived them so we can (hopefully) spend many years together as a family.
Women do indeed deserve respectful, competent care, but your aim is clearly to set up an adversarial relationship between women and their doctors, all while promoting homebirth, a practice that is demonstrably more dangerous for babies than hospital birth. You need to drop the “feminist” from your title because there is absolutely nothing feminist about encouraging women to make decisions based on faulty information. In fact, I think I have come up with a new handle that fits you far better: “The Essentialist Breeder.”
I have an idea! Lets have moms lick their baby clean after they give birth! That would surely douse them with mommy bacteria AND it would be uber natural, just like eating the placenta!
Awwwww, like a kitty 😀
I have heard people suggest that in seriousness. Ha ha.
Gut flora goes along with dietary fads for fashionable psuedoscience at the moment. Take a bit of actual knowledge, misapply it, misundertand it, exaggerate it, simplify it, and you get faecal transplants for good health and ”fructose is poison”. You know, because some doctors were once wrong about smoking. Sigh.
This is what my friend (natural flu shot/essentials oils heal broken bones) posted and said “doctors will tell you vaccines are safe, but they also used to say smoking was safe”.
Because advertising accurately reflects scientific opinion.
But then again, it’s kind of a misdirection, right?
It may be true that more doctors smoke Camels than any other cigarette. But how does that mean “doctors say smoking is safe”?
Maybe 2 doctors in the world smoke Camels, and 1 doctor smokes some other brand. That would mean that more doctors smoke Camels than any other brand. But it doesn’t mean that any doctor means smoking is safe. Shoot, only three are smoking, and we don’t know if two of them do it because they got addicted as teenagers.
As far as I know, that advertisement might even be true yet today. That doesn’t mean doctors think smoking is safe.
This is why the tobacco industry got hammered for their advertising. It’s totally misleading.
My father points out that they called cigarettes “coffin nails” when he grew up – 70 years ago. Now, the “safer” advertisements (such as low tar) may have been actually misleading.
There have been health benefits claimed, and attested to by very well-paid doctors. Most are false, some, like weight loss, fall into the “technically true, but with enormous downside” category.
It strikes me ironic that the non vaxers get all worked up about advertising when they always insist people should “do their research”.
It’s not ironic if they consider reading advertisements as “research”
Oh yes, I forgot how they don’t actually do research. Have you seen the “things anti vaxers say” page on Facebook? These people can’t even spell, and they expect us to respect their cobbled together theory about vitamin C curing Ebola.
OT: does anyone know if you had a baby with a short umbilical cord if you’re likely to experience that issue again in subsequent pregnancies?
I think that no one knows.
Thanks! 🙂 My SIL had a home birth with her first and ended up having a really short cord. I know she’ll continue to have home births and I’m just freaking out that there’s a possibility that could happen again, but without the good (lucky) outcome.
Why would anyone avoid a needed C-section even if they strongly believed this microbiome crap? How helpless are these women? Stick your finger in your vagina and spread the goo on your baby if you are so worried! Who is stopping you?
That’s already happening, I’m sure.
It is! Look on Dr. Amy’s recent post on Microbirth.. someone posted that a post C/S woman inserted gauze into her vagina then smeared it on her newborn…
So “problem” solved then! End of discussion you would think. But no, because their real motivation is not worry about the microbiome, but rather demonizing C-sections.
The real issue is that c-sections steal the baby’s soul. Microbiome is just a sciency-sounding excuse.
Gross!
Shut up, Id lick that…
The amount of pseudo-science out there is mind boggling. Look at all the crap in the world of nutrition. Look at all the folks waxing on about the “dangers of wifi and radiation from mobile devices”…. right now its not hard to think of more than a few victims of these snake oil salesmen.
Nutrition is the worst. Half the people who go into it are woo-believing idiots, the other half have eating disorders.
Authority figures in my town like the local library’s management keep inviting one or another “Certified Health Coach” to give lectures. I keep trying to teach them that these people are fake dieticians and we need to stop endorsing fake credentials, they don’t get it.
Keep in mind, there’s a lot we don’t know about nutrition, and what we do know for sure is pretty boring: “Eat fruits and veggies. Exactly which ones is probably not super important, aim for a variety. Don’t overeat. Um, actually I’m done. Next!”
As tired as I am of Michael Pollan, the “eat food, not too much, mostly plants” thing is pretty sound.
Though maybe not all that sound, considering the Listeria outbreak that came from fresh organic fruit. Pregnant readers, wash your fruit.
Aaagh I am so sick of the fads: organic, no fat, quinoa (which doesn’t seem to have made Bolivia into a superpower despite thousands of years with it as a staple diet) no sugar, no dairy, no gluten, on and on it goes.
And absolute conviction that everyone else is poisoning themselves, and their families, with all the fresh fruit, veg, meat etc we’re eating from the shops. Next year it’s a different lot of superstitions.
If it isn’t expensive, time consuming, difficult to source and challenging to prepare, it won’t do.
“If it isn’t expensive, time consuming, difficult to source and challenging to prepare, it won’t do.”
A bit like extreme AP, don’t you think?
It’s an extension of AP–once the children aren’t babies anymore, the extreme APers have to invent reasons for why they are raising superior children.
Quinoa has a pleasant texture.
But it’s so nice after having been there (I masked eating disorders with raw veganism in my teens) to jump off and realize foodstuff is just foodstuff. What a relief.
My problem with quinoa isn’t the taste, texture or anything in particular about it. I buy and eat the local one if the mood takes me, which it mostly doesn’t.
My problem with it is that we are importing ‘organic’ (whatever that means) quinoa from Bolivia, which even with the organic growing and the shipping is half the price of the local one, thereby depriving the people of Bolivia, who can no longer afford their staple food.
With quinoa, the sense of entitlement and obliviousness to the bigger picture is what riles me.
Thank you, that’s my objection to eating imported quinoa as well. You worded it perfectly!
I’m Irish.
I could follow a local, organic, sustainable, gluten free diet if I want, by eating the potatoes grown in the fields near where I live. Of course, that is also cheap and easy, so it has no cachet whatsoever.
My sister’s boyfriend is Coeliac (properly Coeliac, not a faddy eater), so I just go into potato mode when he visits and buy a loaf of gluten free bread (because I can’t subject guests to my baking).
I don’t find it particularly hard to cook for him, and I object to making different meals for him, so everyone just gets something he can eat. Dauphinoise potatoes, roast chicken with thyme and lemon and seasonal vegetables went over quite well last time.
So many nice things you can do with potatoes and rice, so I would only suggest getting into the store bought, expensive, oddly textured and not particularly healthy gluten-free substitute foods like breads and pastas if you have to or if you develop a particular fondness for them.
Me…I have a carb cupboard in my kitchen with all my noodles, pastas, rice, couscous, prawn crackers, polenta, quinoa, poppadoms etc in it. Not a big bread eater, but I love all that stuff, and I keep it in one place for ease of use and so I can grab it and pack it up quickly in case of a zombie apocalypse.
Sounds great, what time do you want us?
And of course you’re right, it is perfectly possible to live a gluten free life without making a song and dance about it, as my sister-in-law does.
But where would be the point scoring ‘fun’ in that?
Those of us with lots to do in our personal and professional lives tend to have a bit much on to be agonising over food, beyond hoping the odd vegetable passes the children’s lips and seeing to it that everyone gets to sit at the table and share a wholesome meal.
It’s the faddists who drive all over town, fuss around, and couldn’t put a roast on the table (with or without gluten) to save themselves that make me crazy.
For the Americans, Trader Joe’s has great brown rice pasta and gluten free bread that is tasty. We’re not big bread or pasta eaters but it’s nice to have the option.
(OT – for a pair of lazy vegetarians, Trader Joe’s is just the tits. Wonderful inexpensive pre-made vegetarian stuff for oven or microwave. The local Safeway is going all Amy’s, which is overpriced and tasteless and covered with NON-GMO labels.)
It’s nice when food can be just food. Not magic, not medicine, not morality.
The whole “gluten free” thing seems like such BS to me. The other day I was serving breakfast at a school campout and couldn’t believe how many kids had to pass up the bagels because they were on “gluten-free” diets. I have to wonder why in the many thousands of years the human species has been cultivating wheat it’s only been in the last four or five that people have suddenly started realizing how “toxic” it is.
It’s helicopter parenting gone mad. Well, madder…
And I think the “gluten free” craze has diluted the message for people who have Coeliac disease, and therefore really must avoid gluten to avoid long term complications. They get lumped in with all the other idiots who imagine all manner of ills related to bread and pasta.
That’s very true and I’m proof of that. I dismissed Coeliac disease as being a part of that fad until I finally got some authoritative information on the subject and learned that it is in fact a real disease–it gives the “gluten sensitive” crowd some scientific basis for their claims (“Coeliac disease is real! Therefore so is gluten sensitivity!”) but that doesn’t make it any less real. Sadly, though, when you’re surrounded by nutjobs who won’t let their kids eat a bagel it’s easy to just roll your eyes every time someone says the word “gluten.”
It’s pretty awful… I knew a couple people with Celiac a few years back, and they would even report getting eyerolls from waitstaff when they brought it up! It’s insane.
It always gets me to hear people say they’re ‘trying to cut down’ on gluten. If you have celiac disease, you need to eliminate it, not ‘cut down’ on it; if you don’t, just eat it, it’s fine. I just reply with a slight variation on Monty Python. “I’ll have your gluten – I love it!”
Tangentially, my husband tried to text “Guten Morgen” to a German friend, and it auto-corrected the first word to “Gluten.” I now joke that we’re on a guten-free diet.
In my experience, many of the people trying to “cut down on their gluten” are really just trying to eat a low-carb diet. For some reason, they don’t want to admit to that, though.
I have to wonder why in the many thousands of years the human species has been cultivating wheat it’s only been in the last four or five that people have suddenly started realizing how “toxic” it is.
One reason is that the prevalence of celiac disease has risen sharply and no one knows exactly why.
http://www.mayo.edu/research/discoverys-edge/celiac-disease-rise
Maybe related to the fact that other allergic and autoimmune diseases are on the rise? (Also not a fully-answered question.)
The wheat that is commonly produced now bears little resemblance to older varieties of wheat. My understanding is that artificial selection has produced wheat with higher levels of protein.
Also, because we live in an era of processed foods, people are more likely to encounter wheat without eating traditionally “wheat-y” foods, like bread and cake.
The rates of celiac have gone up. Some speculation on causes:
1) Wheat has more gluten in it than previously.
2) People eat more wheat.
3) People with celiac live longer and are more likely to have children.
Of course, much, if not most of the gluten-free craze is rubbish. But there is very good reason to believe that intolerance is on the rise. Remember, there have always been people who felt crummy after eating, or lived with chronic diarrhea. Perhaps many of those people had an intolerance to gluten and were simply told by medical professionals at the time that they had “indigestion.”
That’s probably true, however (with the exception of people who have true celiac disease) I still think it’s mostly hysteria. There was a study done recently where people who claimed to have gluten sensitivities were given a range of diets from high gluten to low gluten to no gluten, and all of the people in the study claimed to have worsening gastrointestinal symptoms regardless of which diet they were on. The researchers of that study explained it as the “nocebo” effect—opposite of a placebo, when a harmless substance creates harmful effects in the people who consume it. There were problems with the study, though, since all the patients in it had IBS so were probably sensitive to other foods they were given, too. But it would be interesting to see this study repeated, say, among all the parents and children at my kids’ elementary school, where gluten intolerance appears to be some sort of epidemic.
Oh, I agree that most of it is nonsense. But there are people with real gluten-intolerances. And given that selecting for wheat protein is a major goal of plant geneticists, we can expect the increase in gluten-intolerance to continue.
Most people suffer from a *lack* of protein in their diet (ie, people in the developing world) and so selecting for high-protein grains make sense in terms of improving global nutrition. But there is still that tiny % of the population that will be harmed by that.
As you say, the hysteria only detracts from their very real problem.
DiommedesV “My understanding is that artificial selection has produced wheat with higher levels of protein.”
I keep hearing this claim, but no one ever cites references for it. Do you have one?
These scientists compared older cultivars to newer ones and found that newer cultivars had higher protein content:
http://link.springer.com/article/10.1007/s00122-010-1408-4
Increasing the protein content of wheat has been a major goal of wheat geneticists. Much effort has also been expended trying to elucidate the interaction between genetics and environment in controlling protein content, because there is clearly a strong effect of environment (ie, growing season) on protein content. Specifically, there seems to be a tradeoff between protein content and total yield (this is not uncommon for cultivated grains).
Bottom line: improving wheat protein has been the goal for wheat geneticists for a very long time. Go to Google Scholar and search for “protein wheat” and you will see many citations, including a really great paper in Science that reported on a QTL that affects many wheat phenotypes, including protein production.
http://www.sciencemag.org/content/314/5803/1298.full.
Also, because much of this genetics is proprietary, what is available in the scientific literature is a small sub-sample of the efforts to increase protein in wheat.
Sorry, showing my lay person’s ignorance here … but why is wheat that contains more protein a problem? Is it harder to digest?
Actually, it would be more accurate to say that the first paper is about the diversity of gluten proteins.
Here is the kind of paper I’m talking about:
http://link.springer.com/article/10.1007/s10681-006-9185-5
The authors acknowledge the goal of improving protein content, then compare two different methods for predicting which genotypes will perform well in a given environment and can be used for selection experiments.
DiomedesV, thank you!
Hi I had to speak up as one of the 1:100. A few years ago I tested positive for Celiac disease (Diagnosed by an objective blood test! Ordered and interpreted by a MD gastroenterologist!). The only reason I was tested was because my sister had gone to a GI with vague abdominal complaints and the tTG part of her workup came back positive. Her doctor then recommended that all of her first degree relatives be tested which led to my diagnosis. I was shocked since I never* had any GI symptoms myself.
I have mixed feelings about the “fad” part of the diet. On the one hand, the fact that it IS a fad diet has made it easier to find the gluten free foods I need for my legitimate medical condition.
On the other hand, I HATE getting lumped in with all the people who now have a “gluten sensitivity” because of something they read on a woo-filled Internet site. It drives me bonkers when someone tells me they also “feel so much better” since stopping gluten and then start eating the icing off their (gluten-filled) slice of cake.
Anyway, I just wanted to remind everyone that there are non-woo people out there who will also pass on that bagel. Although I probably won’t even mention gluten unless you try to push the bagel on me. Also, my children eat gluten and will continue to eat gluten unless there is objective medical evidence that they need a gluten free diet. So they probably wouldn’t fit in at that school camp out either 😉
tl;dr
Some people have a medical reason not to eat bagels.
*No GI symptoms I thought. I used to take Zantac 3-4 times a month, but since going gluten free I haven’t taken a single one. At the time I had just blown my symptoms off as “indigestion” which I think someone on this thread had speculated about.
I’ve heard the gluten-free thing is because the wheat is genetically modified or something like that.. who really knows? I think it really just boils down to eating a well-balanced diet and everything in moderation.. wish I could follow my own advice though.. it’s hard to do with a wicked sweet tooth!
”Nutrition is the worst.”
You bet! The proponents of the ”fructose is poison” myth are selling lots of books atm. I love challenging them on the physiology, which, of course, gets me labelled as arrogant and condescending, and ”just because you have a degree”. Sigh.
Sometimes after I encounter the pseudoscience stuff on my facebook or pinterest newsfeeds too many times, I just want to come and sit here in this comment section because I feel like you guys are the only sane people on the internet.
For quite a while, I would reflexively look at this site after pretty much every visit to MDC, just for a detox. Then I just quit going on MDC and following a lot of Facebook pages and groups, but I still come here for a shot of sanity when the woo creeps in too strongly on the people & groups I still follow.
Some handy Facebook groups to belong to so you can visit them and cleanse your palate when needed:
https://www.facebook.com/groups/AntiAlternativeMedicine/
https://www.facebook.com/groups/GMOLOL/
https://www.facebook.com/groups/647312642031450/
And, of course, Fed Up With Natural Childbirth et. al.
Though I’ve found that the people in the first three groups aren’t as educated or well-spoken (written?) as the commenters here. Lots of comments that amount to, “I can’t tell you why this is wrong but it’s stupid” or “this sounds like woo, WOO IS EVIL AMIRITE LOL!!!!”
My daughter insists on warming the baby’s bottle in a container of hot water, rather than putting it in the microwave for 20 seconds. Moreover, the hot water can’t have been heated in a microwave oven, either, lest the “radiation” in the warming water penetrate the plastic of the baby’s bottle. Nothing I say can convince her otherwise. She read it somewhere.
Shame on her. Hasn’t she read up on the evils of heating plastic? Her bottles should be made from unicorn horns : )
I get the impulse to want the best for your baby. That impulse is what the snake-oil salesmen exploit. Get her a kids book on physics and at least she can learn there’s no “radiation” in her microwave.
My favorite counterargument to that is, “Are sunburns contagious? Can you catch a sunburn if the person sitting next to you on the bus has one?”
It’s true that you aren’t supposed to warm a bottle in a microwave, but that’s because the milk is heated unevenly. In theory a hot spot could burn the baby’s mouth.
This is my understanding also…everything I’ve read on safe bottle preparation states to not warm bottles up directly in the microwave, not because of fear of radiation and such, but more because of the “hot spots” that the milk gets by heating it this way. It’s a scalding hazard to the baby. Warming it up under hot water, or in a cup of hot water is much safer in this regard.
Can’t hot spots be avoided by shaking it up some after you remove it from the microwave?
I would never advise to anyone. However, yeah, that’s a way to do it. However, it’s not as simple (at least at the beginning) as heat and shake. For the first while, I’d do it more like melting chocolate chips – heat a little, shake, heat a little more, shake, etc until you get to the right temp.
OTOH, if you are going to go through all that, it is almost easier just to use hot water on the stove.
We would put in the microwave for 10secs, shake, serve. Never had any issues.
But only do that after you have established the characteristics of your microwave, bottles, shaking, etc.
As I said, start by doing it carefully. Once you know what works in your kitchen, then you can modify.
Yes, if the bottle is not full you can shake it, let it rest a bit, then shake it again. (If it’s full then the milk can’t move around enough.) I think most people use the microwave to heat bottles and most people don’t end up rushing to the ER with a baby with a scalded mouth, so the risk is not huge. Still, the official recommendation is not to use the microwave at all.
A classic example of how recommendations to parents are based on the “lowest-common denominator.” Another example: Don’t ever let a child under 2 years watch any screen. EVER! Even 2 minutes will rot their brain!
Yeah. Only a genius could figure out how to heat it for 30 seconds at 30 percent power, then shake it vigorously.
The point is that she has it half-right. She’s right about the recommendation. She’s wrong about why.
Are you talking about plastic bottles or liners? If so, plastics which are labelled ‘microwave safe’ have passed testing (FDA regulated). Chemicals from the plastic (like diethylhexyl adipate) can migrate into the formula or milk, during the heating process. If a plastic container is no FDA approved for microwaves, it hasn’t been proven to be safe.
I never heated my daughter’s formula. Problem solved! ;P Seriously though, not doing this from the start made night feeds especially easy. I put the needed amount of water in her bottle with the measure formula in a container – added formula, shook, grabbed her from the side bed co-sleeper, popped the bottle in her mouth, burped, and placed her back in her bed. 10 minutes top.
Is there any reason to heat formula made with clean water aside from the kid’s comfort/preference? Because that sounds so much easier…!
We always heated the bottles when the boys were infants–they were born in January, so I didn’t want to fill them full of cold liquid. However, when spring came, and they were older and it was warmer, we stopped heating bottles, because they were happy to take it straight from the fridge.
That makes sense. I have a 1st day of fall kid – 7 yrs old today! 🙂 I live in SF/Bay Area east side and September is one, if not the, hottest months of the year.
I didn’t intentionally do it. I spent the first 2 days in the ICU intubated under knockout sedation – eclampsia – and the nurses, those horrible, horrible ebil nurses fed her formula. I’m assuming they did not heat it since once I was awake, they gave me unheated bottles to feed her. They also hatted her.
Thank you, thank you, thank you Dr Amy and all you wonderful posters for helping me come to terms at long last with her birth and the horrendous emotional fallout from it.
YES. I use tap water and never warm bottles. Night feeds are a breeze when you pre-measure several bottles’ worth of formula and water into several different containers. The most time-consuming part of our nighttime ritual was actually me using the toilet.
We basically did that all along. Worked great.
Then we went camping and discovered that the baby who would happily scarf down 70-degree bottles all day long would rather starve than touch a 50-degree bottle. Which often turned into pre-warming with body heat, because fire requires effort.
“Um, YCCP? Why do you have a water bottle sticking out of the front of your shirt?”
“Breast Feeding.”
Was it Dr. Andrew Weil?
OT: Where’s a good place to go for easy to read, REAL information about epidurals? If I search for information about them, all of the sites that come up are totally woo-ey.
Read this entry on The Adequate Mother. She’s an anesthesiologist so there may be more entries. http://theadequatemother.wordpress.com/2013/02/04/2-cm-810/
This book is free for Kindle. Epidurals without Guilt. http://www.amazon.com/Epidural-Without-Guilt-Childbirth-Pain-ebook/dp/B004IZLZVQ/ref=sr_1_1?ie=UTF8&qid=1411335148&sr=8-1&keywords=epidurals+without+guilt
This book sounds great. I especially like that he discusses the risks of NOT getting an epidural.
I’ve downloaded and started reading this book. It’s awesome! Thanks for the recommendation!
Childbirth education in general has this problem. Online info is either seriously woo, accurate but really vague and not terribly informative, or so technical it is useless to the average person.
For example, if you’re trying to find information on cesareans and your likelihood of needing one and why, the only straightforward answer I have ever found on the web is a post of Dr. Amy’s from awhile back. Other fact based pregnancy sites just give a little blurb and send you to your doctor (who probably doesn’t have time to talk it about it in depth, which is why your online in the first place). I wish she did more educational posts that discuss the kinds of stuff you would like to take up your OB’s time with.
To be fair, “information on epidurals” is pretty vague in the first place. What information is she looking for? What are the risks? How successful are they? What do they all entail?
These are three very different topics and each could be a complete discussion of their own. If you ask a generic question, don’t be surprised to find a generic answer. And if you ask a specific question, don’t be surprised to get a detailed answer.
I don’t like the “it’s too technical” excuse. If you have a specific question, you should expect a similarly specific answer.
The “It’s too technical” is real though. If I search for “Do epidural drugs cross the placenta?” or some variation thereof, I either get a bunch of woo-ey sites that say yes, or straight up research papers. If I have a friend I’m trying to calm down, I obviously don’t want to send her to the woo-ey sites, and she might not be able to read and understand the studies. I need a middle ground where someone can translate studies to something easy-to-understand even for someone who’s not very educated.
I think the Mayo Clinic fills that middle niche pretty well: http://www.mayoclinic.org/healthy-living/labor-and-delivery/in-depth/labor-pain/art-20044845
I like this bit: Labor and delivery are unpredictable. Labor pain might be more intense than you expected, or it might hurt in a different way. Even if you have a plan for managing labor pain, you might change it as labor progresses — or your labor might prompt your health care provider to suggest a pain relief option that wasn’t in your original plan.
Keep in mind that birth isn’t a test of endurance. You won’t have failed if you ask for pain relief. One thing is certain: The more you learn about options for managing labor pain, the more prepared you’ll be to handle labor — however it unfolds.
I searched Mayo some more and found there are a lot of articles discussing different aspects of pain relief in labor: Mayo Clinic articles on epidurals
What you quote is not an answer to anything. It’s all vague generalities.
Nice general advice though-be aware things mightn’t go to plan, keep an open mind, don’t think a change of mind is failure, be kind to yourself.
It’s challenging to get through to people who are trawling the internet looking for validation of their point of view. if during your forty minute love-in appointment Midwife Crazy has told you all the terrible things that will happen if you go to hospital, the calm reasonableness of the quoted remarks might not sink in. It’s got to be about attracting the fence-sitters and getting through to them. Or, as we sometimes see here, being available for parents who have had bad experiences and are looking to understand why.
Yeah, but the topic is “finding information about epidurals”, not “nice, general advice”
It’s true. And frustrating if you actually want to know about epidurals. But if you’re just there to be reinforced about how evil your current provider is, with epidurals as the hook, maybe, just sometimes, a glimmer of light is iet in.
I’ll take the 1% where I can get it and leave the perfect world for others to work on.
“If I search for “Do epidural drugs cross the placenta?””…
This is a great example. The general population doesn’t have the medical knowledge to even start to understand this issue. They sit there and debate whether epidurals cross the placental barrier or not without realizing that IT DOESN’T MATTER. Epidurals use *tiny* amounts of *safe* medications. Whether *miniscule* amount of these safe medications occasionally leak out of the epidural space and into the maternal bloodstream and then cross the placental simply does not matter. It’s like worrying about somebody farting in China.
It becomes an issue when the NCB are telling you that it DOES matter and that you’re going to have a high/impaired baby as a result. I saw that repeatedly on NCB sites when I was pregnant with #1, and there was literally nothing but this site refuting it. That’s when a non technical response matters a great deal.
I encountered a pregnant woman posting online, worried that her prescribed steroid medication might hurt the baby. Asked for more details, she revealed it was a steroid EYE DROP. I thought she was talking about Prednisone pills or something from the first post.
Drop in the ocean of your bloodstream, lady, and most of it is staying put in your eye.
Maternal blindness certainly would affect the baby, however.
Technology is getting better and better at detecting minute quantities of ‘things’ (technical term) in many matrices. But I think what gets lost is that the important part is knowing what detecting ‘X’ at a given concentration really means. It’s like people who freak out about the miniscule quantity of formaldehyde in some vaccines, not realizing that we make more formaldehyde than that as part of cellular metabolism.
(There’s also the whole issue that assay signals can get complicated in biological matrices below certain concentrations, but that’s a whole nuther complication – it gets covered under the general premise of ‘if it doesn’t have an effect, it’s not a meaningful concentration.’)
But if you know enough to ask “does the epidural cross the placenta” are you really so technically incompetent to not understand the answer?
5050 says that “the general population doesn’t have the medical knowledge to even start to understand the issue” but the general population doesn’t even have the medical knowledge to ask the question in the first place!
I disagree that they are debating about whether it does. Most of the population doesn’t even think about the safety of epidurals in terms of the question “does it cross the placenta.” They think it is an issue of babies getting high on narcotics.
The problem is finding information that I can share. I personally might understand the studies that come up (and I might not), but a lot of my friends won’t. And if the answer is buried in a complex study, no, I might not be technically competent enough to dig it out or to be able to understand it enough to explain it to my friends in a simple way.
Part of the power of the NCB movement comes from their simple (albeit totally false) statements – “Epidurals will hurt your baby! Epidurals will make you high!” And yes, woo sites say things like “Epidural drugs cross the placenta,” so the general population might read that and become worried. It isn’t a great counter-argument to say, “Here, read this twenty page research paper to understand why that’s false.” It’s a lot easier to direct friends to sites with clear, concise statements that rebuff NCB rhetoric. Like fiftyfifty’s statement below, “Epidurals use tiny amounts of safe medications. Even if miniscule amounts of these medications crossed the placenta to your baby, it would not hurt them.” That’s something anyone can understand.
Yes, the general population thinks about it in terms of the baby getting high on narcotics. And NCB preys on this misconception and dresses it up with the very technical sounding jargon of “crossing the placental barrier” and voila, it seems legitimate to everyone without real medical/science training. Asking a question about crossing the placental barrier doesn’t reveal more knowledge than the general population, it just reveals more expose to woo. It’s similar to using the word “quantum”, it’s a sign of ignorance + woo exposure.
But it is a problem. A LOT of people have literacy barriers, and the kind of technical literacy required to read and make sense of actual research papers is quite rare even among the college-educated.
Actually, no one is really qualified to read papers in every discipline. Even me ; ).
There are lots of situations in which I am smart enough to ask the question, but not educated enough to reliably find and interpret the answer myself.
And judging by the number of comments here that start out with “OT, but there’s a lot of medical providers/smart experienced people here, and I have a question”, I am not alone.
Oh, yes. The trick is to recognize when you don’t get it yet, and go out and look for help if you actually need to know.
I had this issue today with the Tdap shot. My husband put off getting it, and now he’s worried that, if he gets it to soon to when the baby is born, he will be shedding virus and could infect the baby. Well, when you run a Google search for “shedding virus after vaccination,” all of the first page results are either anti-vaccination websites or research papers from medical journals. It took some scrolling to find the one website for lay people that explained the topic clearly.
Spork,
there are no live viruses in the TDaP. All 3 diseases are bacterial, not viral. And the “a” in aP is *A*cellular pertussis – which means there is no pertussis bacteria in it either, just antigens.
Shedding can only be an issue with live virus – Oral Polio vaccine, MMR, and if you get a live flu vaccine. The Salk version of the polio vaccine (iP) in use in the US is inactivated virus.
If you need to direct your family to accurate vaccine information, try CHOP (Children’s Hospital of Philadelphia): http://www.chop.edu/service/vaccine-education-center/
Actually, with MMR only the rubella component sheds whole attenuated virus in very small amounts and has never once been shown to cause illness in another.
Worrying about shedding from pertussis vaccine really is silly if you know any biology. It’s like worrying that your steak in the fridge is going to stampede you, since a steak bears about as much resemblance to a live dangerous cow as acellular pertussis does to infectious bacteria.
But yes, in antivaxxer world, shedding is dogma, so they can feel smug by telling themselves that the vaccinated are the ones causing epidemics.
Thank you! I had a lady at my church tell me her DOCTOR told her she couldn’t be around newborns (I have one) because she had just gotten Tdap and the baby could get it from her. I promptly told her that I had gotten my shot before I even came home from the hospital with the baby– didn’t go into details about the implausibility of her doctor’s info, but wonder where her doc is getting his information? Obviously not from the right place.
Or it could have gone something like this:
Doc: It’s possible for an adult to have a mild case of pertussis and be spreading the bacteria all around without even knowing it. So if you are an adult who plans to be around infants, you should get your Tdap booster, especially if you are around newborns because they can’t get immunized until they are 2 months old.
Patient: If I get a Tdap booster I can’t be around newborns because I will shed the virus [sic] for 2 months!!!
True. I hope it was just a misunderstanding. At least the doctor gave her the shot.
I realized not that long ago that there’s a local pediatrician (Dr. Stephanie Cave) that writes and promotes antivaccine woo & integrative medicine. Of course, I found out about her through the NCB group here. I got into a convo with someone who had “done mega amounts of research” with Dr. Cave’s book, and was spreading the lie that DTaP/Tdap sheds disease organisms.
So it’s not always so simple to assume the patient just misunderstood. Sometimes it really is the docs.
Or her “doctor” is a naturopath or homeopath.
It’s unlikely. She’s really not that type.
Plus, she actually got the shot and I think either of those practitioners would have convinced her that positive thinking works much better.
I went to the website where I gave birth thinking it’s a good hospital specializing in women’s health and following evidence-based best practices, so there should be some good information there. Not! It’s full of woo, such as this:
“Your baby will stay in your room with you 24 hours a day unless he or she requires extra care. Keeping your baby with you, with lots of skin to skin care will help your milk to come in quickly.”
Dr. Amy, is there any evidence that rooming in and lots of skin-to-skin has any effect on when your milk comes in?
Also, there is hardly any mention of pain, and it’s not listed under Health Topics, which I think it should be. I think it’s wrong to downplay patients’ pain.
I think the answer is: “No.”.
Lactation is driven by internal hormonal changes, not the baby’s presence. Ask women who have suffered losses or miscarriages.
Dr Amy had a really nice explanation about the mechanism of how lactation occurs recently. It is triggered by the release of the placenta, which sets off a cascade of events and hormonal changes to let lactation occur.
After the conversation in the comments section of that post, I think my rote response to lactivists will now be, “Caesarean sections give you the best chance to completely eliminate the placenta, and are therefore the optimal way to give birth for breastfeeding.” Just to mess with them.
Ancedata here, but my baby was in NICU right after birth, so no rooming in or skin-to-skin, and my milk came in just fine.
I’m thinking maybe AFTER the milk has already come in, being near the baby might trigger let-down? But that is not the same as lactogenesis.
My wife used to look at a picture of the baby to help with pumping.
This information from the hospital where I had my little ones is pretty straightforward, and there is more in their website. They also used to have a pretty good VBAC booklet up there. https://thewomens.r.worldssl.net/images/uploads/fact-sheets/Epidural-information2.pdf