Most contemporary breastfeeding research is deeply suspect because researchers start with the conclusions — breastfeeding must be best! — and work backward to support it.
As one after another of claimed benefits of breastfeeding have melted away when studies are corrected for maternal education and socio-economic status, breastfeeding researchers have become ever more creative in fabricating fanciful new “benefits.” The latest fad is to claim epigenetic benefits of breastfeeding.
There are 5 reasons to ignore epigenetic claims about breastfeeding, but before we review them some background is in order.
As benefits have melted away when studies are corrected for socio-economic status, breastfeeding researchers have become ever more creative in fabricating fanciful new “benefits.”
What is epigenetics?
Epigenetics refers to mechanisms of gene regulation that determine the state of a cell and that are heritable through cell divisions but that do not involve changes in DNA sequence… It is often more specifically used to refer to chemical modifications (such as methylation or acetylation) of DNA or of the histone proteins associated with it in chromatin. These epigenetic marks can affect gene expression and can be stably inherited from one cell to another (i.e., through mitotic cell division).
The impact of epigenetics was discovered long before anyone understood the mechanisms of genetics, let alone epigenetics. Researchers noted that famine in Northern Sweden in the mid 1800’s seem to affect the health of their grandchildren decades later. In a subsequent observation, children who had survived famine during WW II seem to suffer more cardiovascular disease later in life.
[Lars Olav] Bygren had a long running interest in the lifelong effects of nutrition, and particularly of starvation…
Bygren realized that Överkalix, where he was born, would make for a perfect study. Not only were there centuries worth of birth, death, and agricultural records, but the people living in the remote terrain of Överkalix had remained genetically isolated for centuries.
What did he find?
Among the 1905 birth cohort, those who were grandsons of Överkalix boys who had experienced a “feast” season when they were just pre-puberty—a time when sperm cells are maturing—died on average six years earlier than the grandsons of Överkalix boys who had been exposed to a famine season during the same pre-puberty window, and often of diabetes… It appeared that Överkalix grandfathers were somehow passing down brief but important childhood experiences to their grandsons…
Modifications in response to famine — not of DNA itself but of chemical tags on DNA that control expression of genes — could be inherited.
Breastfeeding researchers promptly seized on that fact to make new claims:
The notion of epigenetic effects of breastfeeding seems to be widely held, and a Google search (January 23, 2017) using the search terms “epigenetics breastfeeding” resulted in approximately 111,000 hits…
At the moment there is no evidence that breastfeeding has any causal epigenetic benefits and considerable reason to ignore such claims.
1. Even with established epigenetic effects, the impact is paradoxical:
For instance, why is it that the amount of food available to a paternal grandfather seems to affect the mortality risk ratio of his grandsons but not his granddaughters? Or why is it that the food supply of a paternal grandmother is only associated with the mortality risk ratio of her granddaughters? Pressing even further, why would a reduced risk of cardiovascular death be linked to a mother’s good food supply but also to a father’s poor food supply? Right now, we just don’t know the answers to these and similarly complex epigenetic questions.
2. To date, most epigenetic associations involve environment, not exposure to specific substances.
An environment of famine or plenty has been shown to have epigenetic effects, but single foods have not. It is entirely possible that any epigenetic impact of breastfeeding has more to do with the amount of breastmilk (or formula) available than with the substance itself.
3. Although we don’t know for sure, it is assumed that epigenetic effects are adaptive.
The epigenetic impact of famine is different than the epigenetic impact of plenty because famine requires different adaptations to maximize survival than plenty requires. Famine is a recurring theme in human history; it makes sense that humans would have developed adaptive strategies to improve survival.
In contrast, whether or not a specific food (e.g. wheat, honey, deer meat) is available does not seem to impact survival so there is no reason to “adapt” to it. Unless and until we can show that specific foods matter, there is no reason to believe one — including breastmilk — has any epigenetic “benefit” over any other.
Moreover, until recently there has been no safe substitute for breastfeeding. Therefore it is difficult to imagine why breastmilk would have induced epigenetic adapatations.
4. Socio-economic status almost certainly has an epigenetic impact.
Differences in socio-economic status creates differences in environment. Children growing up in poverty have a completely different set of biological challenges than those growing up with wealth. Impoverished children may experience a longterm evironment of food scarcity, contaminated water, inadequate heating, and limited or no access to treatment for common health problems. They may develop epigenetic adaptations to meet those challenges.
Socio-economic status is already a confounding factor in breastfeeding research. In industrialized countries breastfeeding is closely tied to higher economic status. Almost all the health “benefits” of breastfeeding are benefits of wealth. Similarly, any epigenetic “benefits” of breastfeeding may actually be epigenetic benefits of wealth.
5. The prenatal environment may lead to epigenetic changes that modulate infant response to the postnatal environment.
Newborn babies aren’t new. They’ve been growing and developing for 9 months before birth in an environment determined in part by their mother’s environmental exposures. It is highly plausible that starvation, pollution, environmental exposures such as those to tobacco and alcohol and maternal illness could have epigenetic effects on the developing fetus. These pre-existing epigenetic changes may modify the impact of breastfeeding on babies. At the moment these cannot be teased apart from epigenetic effects of poverty or theoretical epigenetic effects of breastfeeding.
The claim that breastfeeding has epigenetic benefits — in the absence of evidence of causation of any kind — is a sign of desperation among breastfeeding researchers. As previously claimed benefits evaporate when exposed to greater scientific scrutiny, breastfeeding researchers have had to plumb deeper for new “benefits.” But the bottom line remains the same:
Breastmilk is milk, not magic, no matter how vehemently breastfeeding researchers insist otherwise.
Who even thought of the whole breastmilk is magic thing? It’s just milk.
Dunno, but a Roman dude used colostrum as a term of endearment: “Meum mel, meum cor, mea colostra”:
“my honey, my heart, my colostrum”.
I’m being a rebel today. MrC and I have a grandparenting class at the hospital where is daughter will be giving birth next month. It’s a BFHI hospital. I’m taking my coffee in my favorite travel mug. https://uploads.disquscdn.com/images/7ad59a704468a9459522c956ff489e3fc4394546cbcff2b74b2aaef1c478403a.jpg
Ooh, if some of your birds can talk, you could get them to say ‘fed is best!’ to people.
We’ve been trying to teach Goofy to say “good morning” for 20 years. I won’t be getting my hopes up. Though Frankie (the one in the picture) has the “F” sound down pat, as he tells people to fuck off when he gets mad.
It went okay. I got mad at one point and left the room to calm down. But Richard called them out on non-inclusive language and called the BFHI a bunch of extremists and plugged Fed is Best, and then I used an opening in regards to PPD to bring up other issues, so at least some information is out there that wasn’t there before, at least for this group of grandparents. And to her credit, when i talked about my group, she was happy to hear about it and had me write the name of the group on the white board. So a mixed bag, but overall ok.
Good! Unfortunately the BFHI nonsense is damn near omnipresent.
Excuse me for asking, but, having raised your own children, why should you need advice on how to “grandparent”? BTW, mazal tov in advance and you are going to love it.
It’s more designed to highlight the differences in recommendations between now and when our own babies were little. For example, when my babies were little, bumpers were still recommended and “back to sleep” was just starting. When MrC’s kids were babies they were told to put babies to sleep on their tummies. Most grandparents haven’t stayed eyeball deep into maternal/infant health advocacy and might not be aware of the changes in infant care recommendations. Overall, it’s a great idea. I was disappointed at some of the things, but I expected those things to happen. I was pleasantly surprised at others.
Yay you guys! That’s great.
If you have a look at Hannah Dahlen’s website and online personal statement pages (the university one she’s affiliated with and various other professional sites) it goes on about how she is an expert in epigenetics and carrying out research into its effects. Now I’m not academic, I’m a bog-standard middle of the road NHS doctor, but all I can see from her info is that she chairs some sort of discussion group that sits around producing reams of guff and speculation, none of which is proven, and none of which she will be able to prove because, quite frankly, she doesn’t have a bloody clue about science. And yet she touts herself round the midwife conferences quacking about her research and findings-its pure speculation, not research (unless it’s the sort of ‘research’ people do online to edumacate themselves against the evils of vaccination)
As much as anything else, this can only – ultimately – have the effect of discounting epigenetics as a science. If it becomes associated with quackery and unqualified people touting themselves as such, surely it can only do reputational damage to what may or may not be a legitimate field.
Absolutely. It’s a fascinating area and potentially very significant, but Dahlen has pounced on it and immediately twisted it in such a way that she can claim it supports her core beliefs (breast is best, natural unmedicated birth is best) and it simply doesn’t, as yet, do anything of the sort. But the problem is, she’s presenting it to an audience which isn’t properly equipped to challenge that, or to form their own opinion on the evidence. I’m not saying this to impugn the scientific literacy of midwives, but its a hugely complex area-I do a lot of genetics in my specialist area (paediatric pathology) and I struggle to get my head round it. But she has simplified it, stripped out a lot of the uncertainty, the reservations and qualifications that the folk properly working in this area have been careful to emphasise and she is presenting it as a done deal that, lo and behold, means she was right all along. And that is fraudulent, unethical and unprofessional.
Yours is the long version, Dr. Tuteur. There’s actually only one reason to ignore epigenetic claims about breastfeeding:
1) It’s total bullshit.
Even less plausible is the suggestion that birth mechanism could carry epigenetic effects – as if a physical process that happens for a few hours (or days, at most) would do anything to gene expression.
Totally OT but on the subject of Junk Science: a post appeared on my Facebook timeline from a chaplain offering a workshop for persons wanting to learn something about caring for the dying and it involved use of essential oils. Major bugbear for me so I suggested the individual add a warning about these being possible asthma triggers. The poster took offense and said, well either one was Called to Do Healing Work with these substances or One Was Not. Yikes. I guess a Sense of Calling trumps allergic tendencies.
In the UK there is a ‘death doula’ movement. Whilst it sounds weird, I think it’s quite a good idea-we’ve lost sight in this country about how people die so having someone there who can support a family through a death might be a help.
I think we should have cats as support animals in hospices. We know stroking an animal helps calm you down, and hearing is the last sense to go, so dying with a purring cat on your lap seems heavenly to me. Plus you’re warm and won’t be moving too much so the cat will stay put. Cats would be far more useful than essential oils.
This is a role that hospice nurses can fill assuming they have time, helping the family to recognize the changes that are ongoing, and giving them a sense of what to expect. The nice thing about the nurse is that she or he can also obtain medical assistance if things go south (severe agitation, pain crisis, bleeding, intractable nausea and vomiting). In the states, “death doulas” are pure and total woo. We had one in my area teaching weekend classes with special holding techniques, music selections, you name it. Turned out the teacher had attended exactly one death, which was uncomplicated. Sometimes I think one of my greatest values as a chaplain was the ability to say, “You know, it might be a good idea to call and ask the nurse about this. They might be able to help…” And if all hell was truly breaking loose, to say, “I would feel more comfortable if the nurse knew about this.”
‘assuming they have the time’
That’s the problem though. There aren’t enough hospice places in the UK, and some hospices are quite strict on admission criteria (it was only very recently that one of the local ones here started allowing admissions for people dying of non-malignant disease). The NHS is stretched very thin, people want to die at home but families panic and call the ambulance and they end up dying in the emergency room or stuck on a ward with acutely ill but non-terminal patients. Having someone who can explain what actually happens in the hours and days leading up to death might stop families panicking and help them cope. But we need more nurses, more beds, more hospice places-we need more of everything really.
“Therapy dogs” seems a growing phenomenon in Israeli hospices and institutions for the extremely retarded and disabled
Epigenetics is interesting but it’s way too soon for anyone to be as certain as the Natural News types are.
Absolutely. And just wait and see what happens when something comes up that goes against their worldview (someone finds that the best thing you can do for your baby’s ‘microbiome’ is have a caesarean or drink alcohol or whatever). The field is so nascent that I honestly think it’s wide open for all kinds of interpretations.
“Epigenetics” is the new “quantum”–emerging field of study, lots of big words and difficult concepts, easy to appropriate for all sorts of quackery.
And both of them in particular are oversimplified as “You can change your own reality/destiny beyond what you ever imagined!” Add “if you consume Product or Service X” and you have the perfect sales pitch. The capitalist-individualist status quo is maintained in the name of bravely challenging popular oversimplifications of the late 1800s science that they still teach in school because it still works as a good enough, only slightly excessive, simplification for most practical purposes.
Gah, that and “microbiome.” The Atlantic looooves to run articles about autism and the microbiome!, obesity and the microbiome!, violent criminals and the microbiome! So many people then link their friend or family member to the article telling them to take their probiotics or eat their yogurt. Of course, you gotta a few anti-vaxxer nuts proclaiming, “Just like Wakefield said!”
The microbiome is today what antioxidants and flavonoids were 20 years ago.
Anyone who actually understands anything about either epigenetics or the microbiome understands that while they are both fascinating areas of research, we really don’t know enough about either to make any definitive statements or recommendations. At least that’s been my experience when working with or being taught by professors actually studying either epigenetics or the microbiome.
Does it? I thought the Atlantic was an entirely sensible publication. I can’t see their new editor (Prof John McWhirter) having much truck with that sort of BS, anyway.
I don’t know when the new editor came on. On their Facebook page, they run the same old bad science journalism on a daily basis. I see that article where Dr. James Hamblin didn’t bathe for some number of months on at least monthly.
As long as a newspaper needs to attract ad money, and as long as health and medicine woo are popular among the newspaper-reading crowd in general (mostly people with enough money and/or education to care about well-being and not just getting through the next day), I can’t see a newspaper abandoning that stuff.
I also can’t find anything about John McWhirter being their editor.