Breastfeeding: Sound Science, Clear Evidence

In 2000, the Surgeon General published a report of the federal government in the United States which was entitled Blueprint for Action on Breastfeeding. A very powerful manifesto for a plan for the United States as a country to improve the percentage of women who are breastfeeding their infants. It was built on years of evidence for from reasonably good studies that breastfeeding, at least during the first year of life, if not extended longer, but certainly through the first year of life, had a significant benefit in improving the function of infants over alternatives. It didn't say it was the only way to nourish infants, it just said that we should encourage greater breastfeeding as a way of providing nutrition for infants. And then in 2001 in the JAMA, a very powerful clinical intervention trial was published, the most significant trial ever done, 7,000 mother infant pairs in this particular trial called the PROBIT study Promotion of Breastfeeding Intervention Trial P R O B I T which was done in Belarus. And the reason it was Belarus was a place where they had very similar hygiene and sanitation as one would have in the United States, but they had obstetrical and care units that were very similar to the way that was in the United States 20 years previously, with more opportunity to introduce breastfeeding for several days to the new mothers. So in this trial, following children that were breastfed and looking at various physiological and outcome parameters, it was unequivocally shown that the incidence of gastrointestinal problems and immune related atop issues was significantly reduced in those children that were breastfed. And in fact, in the end of this paper that was published in the Journal of the American Medical association in 2001, they said our experimental intervention increased the duration and degree of breastfeeding and documented the risk of gastrointestinal tract infection in atopic epsilon eczema in the first year of life is being significantly reduced. They go on to say these results provide a solid scientific underpinning for future interventions to promote breastfeeding. So this is a long standing kind of nutritional fact without a lot of ambiguity it would appear. But just as we recently talked about on a previous edition of our kind of, I guess you call it surprise at as to what's going on presently with the federal government. When we talked recently about the regulations on chlorpyrifos, the particular biocide that was demonstrated over years to have potential risk to children in their development of their nervous system, which was going to be removed from Commerce as of 2018, that was then overruled. That particular change in government policy has also been mirrored in, in this breastfeeding policy as well. And as you said, even though based on decades of research, there was a recent resolution by the United States government's position at the Geneva Conference at the World Health Organization affiliated Health assembly to kind of strike language that would promote and encourage breastfeeding. And the United States delegation embracing the infant form formula interest changed the time, proven advocacy for breastfeeding. And this was considered almost unheard of and unexpected and radical. In fact, the United States delegation brought such pressure on other countries that wanted to endorse this breastfeeding resolution, countries like Ecuador, that they indicated there would be negative repercussions to these countries in terms of aid, in terms of financial support, if in fact they went ahead to vote in favor of this resolution. It was only saved as a resolution, as a consequence, believe it or not, of Russia voting in its support. And the United States government decided it didn't want to take on Russia, but it was going to be willing to take on a lot of these Latin American, Central American and African countries that were going to support the resolution. Now, what does that really mean? Well, you know, there was another interesting paper that appeared or article that appeared in the New York Times in June 12th of 2017, written by a pediatrician, Dr. Perry Klass, who was speaking about her experience as a breastfeeding mother and physician, in which she felt kind of an obligation to stand up and do what she was suggesting to her patients, even though it was complicated for her as a professional. And she recounted kind of both some of the challenges she had, but also some of the positive benefits that she found over the first year of life of her infant. This was her second child in breastfeeding. And so the concept is you can find ways around this as a mother, but it shouldn't be so pressured on the mother that they would feel not breastfeeding their child was some kind of a heinous mistake. In other words, freedom of choice might play a big and important role. Well, this study that I mentioned, the PROVIT study, went on to follow up these infants for many years afterwards, up to 16 years after the initial infancy period, looking at things like cognitive development and neurological function to see if in fact those that were breastfed had changes that could be measured at the age of 16. And it was found in a follow up trial that was recently published in in PLOS Medicine, that breastfeeding during infancy, looking at neurocognitive development, then later in adolescence, wasn't able to show any dramatic changes in the outcome of adolescence. That they could attribute to that of breastfeeding in infancy, other than that of some verbal ability differences that they found in the infants that were breastfed versus those that were not breastfed. The editorial that follows that particular article I think is interesting because it points out that after infancy going on into adolescent development, other factors may play important roles, such as parental oversight, general nutrition, stimulation from their environment that may compensate for differences in neurocognitive development acceleration that are seen in infancy with the breastfed infants. So I think what we can take away from all of this is that breastfeeding continues from a scientific perspective to be the optimal nutrition for infants. And, and it does in fact help to promote proper immune function in those infants that leads to lower incidence of things like atopic disorders, eczema, and certain infectious disorders of their GI tract later in life. It may have some benefit also in neurocognitive development, particularly relates to verbal fluency. But some of those things can be probably modulated by the way the child is stimulated and their diet as they grow older. But for us as a government to not stand by the long standing principle that breastfeeding should be supported and should be encouraged in the face of what appears to be infant formula, billions of dollars of interest to try to suppress this, in that breastfeeding has been cutting into the use of infant formula and reducing the growth of the product and kind of flattening itself its profitability going forward, is one of the most heinous examples of the misuse of information and the perversion of sensibility. So another example, just like our chlorpyrifos example with the development of the nervous system in children, now we have a second example of our own government in the United States of taking a position against that which is scientific, scientific fact, and really a tried and proven rule of reasonableness that breastfeeding is the principally best nutrition for infants. What a shame.