Rapid Responses to:
|
|
Rapid Responses: Rapid Responses published:
-
![[Read Rapid Response]](/icons/misc/sectionDOWN.gif)
Breastfeeding is not always cheap
- Lynne Schyma (27 June 2008)
-
Breastfeeding is cheap
- Patricia Young (30 June 2008)
-
Re: Breastfeeding is cheap
- Jan M. Perkins (1 July 2008)
-
The value of breastfeeding
- James E. Akre (3 July 2008)
|
|
|||
|
Lynne Schyma, Doctor on maternity leave My house, EH5 2GL
Send response to journal:
|
Whilst I wholeheartedly agree with the need to support exclusive breastfeeding, I am not sure it is always necessarily cheap, nor environmentally friendly. Having breastfed my son well past six months, and now my daughter (as I type this!)I am only too aware that is has not come cheaply and without environmental impacts. I have amassed a variety of equipment that was essential for me, that includes nursing bras (at least £30 a time, in different sizes as my shape changed), between 2 and 6 breast pads per day (disposable or reusable ones which would require washing), plastic breast shells, creams, several books on breastfeeding and umpteen leaflets on the subject from the health visiting team. In order to express milk for a bottle so I could have a few hours away from the baby occasionally I needed a breast pump (more plastic), a bottle and a sterilising unit, as well as hot water and washing up liquid. There was also the small order of the extra calories I consumed whilst breastfeeding. I am sure the midwives will argue that some will not need these supplies, I have found that I did, as did other in my breastfeeding peer group. I am sure that the environmental impact is still less than that of bottle feeding (I would love to undertake that study!) but I don't believe breastfeeding should ever be presented as a 'free' option as it certainly isn't. Competing interests: None declared |
|||
|
|
|||
|
Patricia Young, pediatric nurse practitoner 08401
Send response to journal:
|
I am responding to the young mother who said breastfeeding costs. It costs only because she has responded to advertising and purchased things she really does not need to breastfeed. You need 1. a baby 2. a mom with two (or one) breasts. I can remember when I was breastfeeding my youngest and thinking how easy it was to go out - grab an extra diaper and go. I can remember being at the grocery store and being delighted that I didn't have to go down that aisle with all the baby products and baby food. I took a fork and squashed our food into manageable mush when he showed an interest in eating. Breastfeeding is almost free, mom needs about 500-600 more calories a day. The cost of those calories is made up easily by not using the costs involved in formula, plus my babies were healthier. I guess the young mother didn't go to the presentation <www.babymilkaction.org/pdf/mbfwed08.pps> that explains the costs involved. Competing interests: None declared |
|||
|
|
|||
|
Jan M. Perkins, Professor NA
Send response to journal:
|
Breastfeeding is cheap if it works. It is also cheap if minor complications occur in a place where health insurance covers them and is low cost per intervention. And indirect costs are low where there is workplace support, high if there is not. I support breastfeeding without reservation. I was going to breastfeed exclusively and tried to do so. My son nearly died. For whatever reason I could not get adequate let-down. I carried minimally productive painful footballs around for almost a year. I called in lactation consultants, I begged my doctor to prescribe nasal oxytocin, I nursed for hours at a time. I even took my doctor's final suggestion of a glass of wine to relax while breast-feeding. None of it worked. I had a much wanted child I loved, I had two intact breasts. I did everything that was suggested. I nursed my son within an hour of birth, ate well, kept hydrated, and forbade formula. I nursed until my son and I both passed out from exhaustion and (in his case) from starvation. I brought in the much loved mother-in-law, I brought in pumps so I could still try when he was asleep. I even got desperate enough to buy wine the last week. We did daily doctor visits for weighing as he was drastically losing weight and we were about to have him taken into care. Finally my doctor told my husband to wait till I was asleep and give formula or we would lose our child. Within a week he was okay. I still kept trying to breastfeed for seven months longer. He now is taller than me and thriving. I still wish I could have breast-fed, but I acknowledge that my determined attempts to do so, based on the mantra of "anybody can breast-feed," cost the system a lot of direct costs (lactation consultants, doctor visits, other consults) and indirect costs (stress for all involved - including the doctor who delivered him, lost income for my husband and mother in law, my own doctor visits etc.). In addition it almost killed my child. I still feel guilt about not being able to breast-feed. I tried and failed. Twelve years on I still sometimes look at my breasts and think - "you useless lumps." A few months ago I helped a student I met trying to pump milk in a public toilet get a private place at her school to do this. Breastfeeding is not easy in our society and even with all barriers removed there will still be women like me who cannot. I only wish that the pro-breast-feeding system would not insist this is something possible for all women. For most yes, but please stop making the rest of us feel worse than we already do. Jan Perkins Competing interests: breastfed a child who became failure to thrive as a result |
|||
|
|
|||
|
James E. Akre, Author; Public Member, Board of Directors, International Board of Lactation Consultant Examiners 1232 Confignon, Geneva, Switzerland
Send response to journal:
|
It concerns me that comments made thus far about the relative cost of breastfeeding vs. artificial feeding focus largely on the short-term outlay for related paraphernalia and the perceived ease of one feeding mode over the other. I’m not calling into question the points made so much as their relative importance when compared to the multiple, complex and lifelong implications for the health of mothers, children and thus the entire society of observing or disregarding the biological “hominid blueprint” (1) for nourishing the young of our species. It is virtually impossible to place a precise economic value on breast milk. In addition to being so much more than a mere food, it is rarely traded in the marketplace. Nevertheless, in 1994 the estimated value of human milk traded in milk banks in Norway was set at US$2.2bn (2). Even if this represents only a fraction of human milk’s total value, extrapolated worldwide it promptly gives the lie to the all too common – and frankly absurd, even offensive – assertion that breast milk is somehow free. Meanwhile, breastfeeding itself has at least three price tags attached: a mother’s time, which far too many observers mistakenly consider to be “on the house”; the energy cost of producing milk (though an incomparable value in terms of the benefits derived for both mother and child, the daily additional 500 kcal still need to come from somewhere); and the opportunity cost – the cost of doing something in terms of an opportunity foregone – for example mothers who must choose between staying at home with their children and returning to paid employment outside the home to meet their families’ financial needs. Taken together these three price tags provide additional compelling evidence that breast milk is anything but free (3). At birth the infant’s brain is the most undifferentiated organ in the body (4). If genes and early experience shape the way neurons connect to one another, thereby forming the specialized circuits that give rise to mental processes, it is reasonable to conclude that whether this process is initially fired in a manner that is evolutionarily consistent with who we are as a species or relies on a food that is based on the milk of an alien species will make a significant difference in terms of developmental outcome. It is time to adopt this generic perspective as the nutritional basis for ensuring the full genetic potential for every child’s neural development. In multivariable analyses of the early life determinants of childhood intelligence in a population-based birth cohort of individuals born in Brisbane, Australia, Lawlor et al. (5) reported that the strongest and most robust predictors of intelligence were family income, parental education and breastfeeding, with these three variables explaining 7.5% of the variation in intelligence at age 14. What do we suppose would be the cumulative worth, over a lifetime, of 2 to 10 IQ points (6) for the 136 million children born every year (7) if they were breastfed for 12–18 months? Infant formula will sustain life in a pinch, and thank goodness this is so. But from a nutritional and developmental standpoint, not everyone has understood just how hugely inferior it is to breast milk, with negative implications for both children and their mothers – and thus the whole population – across the entire life course. Infant formula pitched as somehow suitable for routine non-emergency use is immediately denatured, thereby forfeiting its only claim to legitimacy – as a life- sustaining crisis commodity. Moving infant formula, once and for all, from the kitchen pantry and permanently relegating it to where it got its start – in the medicine cabinet, for emergency use only – presupposes a major shift in popular, health-professional and political thinking. This begins by ceasing to emphasise the “benefits of breastfeeding” and concentrating on the “risks of not breastfeeding” for mothers and children alike. James Akre akrej@yahoo.com 1. Dettwyler, K.A. (1995) A Time to Wean: The Hominid Blueprint for the Natural Age of Weaning in Modern Human Populations. In: Stuart- Macadam, P. & Dettwyler, K.A. (eds) Breastfeeding. Biocultural Perspectives pp. 39–73. Aldine de Gruyter, New York. 2. Hatløy, A. & Oshaug, A. (1997) Human milk. An invisible food resource. Food Consumption and Nutrition Division Discussion Paper No. 33. Washington, DC, International Food Policy Research Institute. At: http://www.ifpri.org/divs/fcnd/dp/papers/dp33.pdf (accessed 1 July 2008). 3. Akre, J. The really big money (2006). In: J. Akre The problem with breastfeeding. A personal reflection (pp. 147–154). Amarillo, Texas: Hale Publishing L.P. 4. Siegel, D.J. (1999) The Developing Mind. How Relationships and the Brain Interact to Shape Who We Are. New York: The Guilford Press. 5. Lawlor, D.A. et al. (2006) Early life predictors of childhood intelligence: findings from the Mater-University study of pregnancy and its outcomes. Paediatric and Perinatal Epidemiology 20 (2): 148–162. 6. Daniels, M.C. & Adair, L.S. (2005) Breast-feeding influences cognitive development in Filipino children. Journal of Nutrition 135: 2589–2595. 7. WHO (2005) Chapter 4. Attending to 136 million births, every year. In: World Health Report 2005, Geneva: WHO. Competing interests: None declared |
|||