The History Of The Contemporary Issues Health Essay
Breast is best, a well-known phrase amongst health professions and new parents alike, it is always ready at the perfect temperature, the baby gets to bond closely with its mother and it is free: but with advances in technology and the wide range of good quality formula milks available; are the benefits of breast feeding exaggerated? Is the current research flawed and inaccurate? This essay will look into these questions and analyze different studies and science, discussing the different factors and situations where the breast is best. Premature babies, mothers with depression and differing hormone levels. This essay will also evaluate contradictory evidence on intelligence, protection against disease and problems associated with breastfeeding, and look into new research for alternative uses for breast milk and how science strives to create formulas and milks ever closer to nature.
Breastfeeding is said to be the optimal method of infant feeding. S.Jody Heymann (2003). Breast milk provides almost all the necessary nutrients, growth factors and immunological components a healthy full term baby needs. Breast milk also reduces the incidences and severity of certain infections and allergies. It has been said that breast milk can increase cognitive development, prevent obesity and hypertension and insulin-dependent diabetes. Benefits for the mother may include lactation amenorrhea, early involution of the uterus, better bonding with the baby, faster weight loss to pre-pregnancy weight and a lesser chance of ovarian or breast cancer. In most, but not all cases, infections in the mother and medication taken by her do not do the milk any detriment.
During pregnancy, the mother's body prepares itself for breastfeeding; the anterior pituitary gland secrets prolactin which stimulates milk production. During the pregnancy this process is inhibited by the high levels of progesterone and oestrogen. Once the baby is born, the large amounts of prolactin are what causes the mother to produce enough milk, the most important factor in keeping these levels high enough is stimulation from suckling which releases oxytocin which in turn creates the 'let-down' reflex. To begin with this can cause huge amounts of milk from both breasts and mothers have the social embarrassment of leaking problems but by about three months postpartum the hormone levels settle down and the flow of milk becomes more linked to the baby's needs: the more the breast is emptied, the more is produced.
For the first few days after childbirth the milk is different and is called colostrum; this is responsible for sealing the baby's gut and protecting it from foreign proteins thus preventing allergies, so even if a mother chooses not to breastfeed her baby may benefit hugely from suckling for these first few days.
Breast feeding is best because it claims less incidences of sudden death syndrome (SIDS); a higher IQ amongst breastfeed babies is best social skills. (Ahrendsen, 2010).
Nutrition is essential to the health and development of infants and children. Breast feeding is superior to bottle feed because it protects against infection through specific and non-specific immune factors and has a long-term consequences for and other scientific evidence in support of breastfeeding, to clarify why breast milk is a best food for infants than infant formula and to demonstrate support for further breast feeding initiatives in Australia such as epidemiological evidence for the benefits of breast feeding to the human infant against a wide range of illness and infections.
An example: Aptamil is one company of formula milk studying the science of breast milk, they say it is the 'gold standard' for infants and want to create a formula as close to breast milk as possible and they have learnt more about the benefits of long chain polyunsaturated fatty acids (LCPs) found in breast milk and these are now being added to their formula, in particular LCPs 'AA and DHA' encouraging better visual and brain development and gross motor skills (Aptamil, 2009).
Very recently, the ability to track which genes are operating in a baby's intestine has allowed scientists to better compare the early development of breast fed and formula fed babies, some say early differences are very real; the genes in breast milk are fundamental to the development of the intestine and provide an immune defense that formula companies are not yet able to copy. An in depth report has been written on one such study, but this study only included 22 babies; 12 breastfed: 10 formula fed (Science Daily 2012).
Researchers have known for years that breast milk is best for biological reasons. To find out; scientists analyzed the fat in human and cows' milk and found that in human milk, the particles are coated with two sugar based proteins called MUC-1 and MUC-4, these proteins have been previously seen to clock receptors in the intestines that E.coli and other disease causing microbes attach to: cows' milk cannot offer this protection as it does not have these proteins.
The NHS guide called 'Off to the Best Start', given to every new mother, says breastfeeding is the ONLY way to give your baby all that it needs, it clearly states that bottle feeding is not good enough. It lists a long line of health benefits some of which are unproven such as references to support. This leaflet could easily cause mothers, who are for whatever reason, unable to breast feed, feel inadequate or that they are doing their baby harm by not providing all they need to protect them. We now have the ability to create a wide range of formulas suitable for babies with all kinds of special dietary needs. This leaflet goes on to say that your baby will be happier if a mother keeps them near and feeds them whenever they are hungry. This is something bottle feeding mothers could adopt, rather than the 'competition' to get baby to sleep through the night (tiny tummies need regular top ups and it is not always the best thing to let a small baby sleep too long) bottles could be smaller and at more regular intervals; later this essay will discuss how this links with long-term stress chemical release (NHS, 2007).
Many see breast feeding as the best option whether they are successful at breastfeeding or not, as either way they try and fail and feel heart broken or they feel they are seen as a 'bad' mother for failing: or they spurt milk out everywhere without realizing it and look down and notice a large wet patch on their clothing causing embarrassment. More so (and sadly) breastfeeding is still seen as a matter of taboo and even when done in a discreet manner, mothers feel they almost have to apologize for doing what our government describes as 'best' for baby.
A recent study in Brazil found dangerous levels of pesticides and herbicides used to treat genetically modified organisms (GMO) in breast milk being drunk by the babies. The chemicals found were known to do damage to the central nervous system, the immune system and the respiratory system. This study clearly shows that living near to a GMO farm and feeding a child may be potentially lethal. In the UK many of us do not think twice about the food they eat or even laugh at the 'silliness' of organic produce, but there is no denying that the spraying of GMO agrochemicals is affecting humans in significant ways and this may not be such the great breakthrough in agricultural technology that the biotechnology companies would have the public believe (Huff, 2011).
One women's' magazine called 'The Atlantic' spoke of how breastfeeding is socially 'over-favored' by the middle classes. The magazine suggests the 'hard-sell' tactics of leaflets such as the previously mentioned NHS 'Off to the Best Start' and the experts’ web pages scare the mothers into thinking breastfeeding is the only sensible option for a mother, with comments such as "Stoll’s with a butter milk-odor". The writer of the article goes on to say that given a class of eight year olds nobody would be able to tell whether an individual child was breastfed or not (Rosin, 2009).
A popular book used by parents and midwives is 'The Developing child', the 6th edition in 1992 differs greatly in opinion from the 9th edition in 2000, which strongly encourages breastfeeding: earlier editions put the emphasis on it being a personal choice, this suggests advances in science are proving that even though we now have better standards of formula milk, breast milk is still best; science cannot conquer nature (Bee, 1992/Bee, 2000).
It is believed by many scientists now that most of the research carried out on the benefits of breast milk is flawed, a key flaw, according to the researcher Joan Wolf is that the studies are observational, this means they are carried out on women who had already decided to breastfeed and therefore able to determine if there is something different about mothers who chose to breast feed to begin with, be it hormonal, life style choices, IQ, parenting standards, attitude to health or other factors (Patel, 2011).
A best test would be to pick a few hundred mothers and tell half to breast feed half to use a bottle and then follow these children's development and other exterior influences on their development right through to adulthood, or one could research siblings fed differently though a test such as this could be deemed unethical if forced, best to follow women who make own decision.
This finding has been backed up by the Journal of Health, Politics, Policy and Law. It states that while breastfeeding has many disputable advantages, the medical advantages are quite big. It is suggested that those who morally promote breastfeeding have scientific evidence backing up their case and even that evidence is presented accurately.
Mothers who choose to breastfeed for its purported health advantages might also be more likely to promote a healthy lifestyle, which would include a balanced diet and physical exercise therefore on studies of adults; the decrease in obesity or other problems may have nothing to do with the few months of breastfeeding at the start of lie but what happened for the rest of the child's life.
The home birth debate (Tuteur, 2008) says that in an effort to promote breastfeeding; activists have engaged in unethical practices to scare and trick women into breastfeeding. In light of this senior scientists have met and reviewed the situation and now say evidence linking formula feeding to diabetes, leukemia and respiratory disease is insufficient.
Gastrointestinal illness is a minor problem in the UK so although breastfeeding is proven to protect from it; this would not be considered enough reason to choose to feed this way. In developing countries where access to clean water and medical help is limited, this protection is lifesaving. The Daily Mail (Macrae, 2009) talks of flaws in the 'breast is best' motto. The NHS leaflet (NHS, 2007) claims many types of protection but the Daily Mail reports on Professor Michael Kramer's findings fail to demonstrate such a link to most of the proposed protections, ear infections and stomach bugs being the only exception.
Cancer research studies have found that it may not be entirely a mothers choice if they do not breastfeed they have discovered that mothers with high levels of testorerone cannot breastfeed. This testerone is developed by an imbalance in the placenta that converts both testosterone and oestrogen and this takes a lot of energy and if the placenta is not producing enough energy, the oestrogen does not get converted, affecting both mother and baby (Research Information Centre, 2012).
Debates are still taking place as to whether breastfeeding boosts intelligence; The British Medical Journal's research shows a mothers IQ was more highly predictive of breastfeeding status than her race, education, age, poverty status, smoking, the home environment, the child's birth weight or birth circumstances. British Medicinal Journal says that breastfed children are shown to have up to three points higher IQ but when adjustments are taken into account for the mother: no link is found to feeding; another wrongly promoted advantage (Der, 2006).
It has been widely believed that women with postnatal depression would not be able to breastfeed but this has recently been challenged by a number of universities. Many suggest the way that breastfeeding is currently promoted actually worsens the depression and contributes towards feelings of guilt, fear and inadequacy. Breastfeeding makes many mothers feel trapped by the dependency of their baby at the expense of their own well-being: but for some mothers with depression; breastfeeding helped with overcoming as it reassured them of their ability to satisfy, nurture and connect with their baby (Science Daily, 2007).
However, not enough is known about the possible long-term risks to babies of mothers on anti-depressants (Nursing Times, 1996). Even though certain drugs cause excessive sleepiness in the baby and upon withdrawal the infant has jitters, vomiting, and irritability and hypo glycaemia: it is not recommended that a mother on the drugs bottle feeds but instead 'watches out for signs'. This could be considered dangerous long term (GPN, 2007).
When looking at the advantages of breastfeeding premature babies, it appears to be a different story to that of full term babies. It is shown that premature babies on breast milk strive and develop best. However it is thought best that this milk is first pumped (which causes problems of its own (and then fortified with nutrients in hospital (O’Connor, 2003).
The Baby Centre, 2012 say mothers of babies in intensive care are often unable to provide enough milk for their baby who needs feeding little and often, so donor breast milk is widely used to make up for the short fall. The use of donor milk has not been widely studied and the extent to which this pasteurized milk retains the biological properties of mothers' milk is unclear. Donated milk is often 'drip' milk rather than pumped (milk leaked from one breast whilst a baby is feeding from the other); drip milk is low in fat and only contains two thirds of the calories of breast milk. This shows that donor milk is not that good and perhaps a quality formula is better (Stan way, 2009). However formula milk cannot protect from NEC (necrotizing enter colitis) and breast milk can even drip milk. This is a potentially fatal disease that affects over 10% of premature babies so maybe breast milk in this case is the best option after all (Sanchez, 2008).
One study has shown that premature babies whom received fortified mothers' milk (through a tube) had 'significantly' higher IQ at age seven than their peers; even after adjustment for mothers' education and social class. (Lucas, 1992).
When babies are left to cry without receiving a nurturing response as some routine bottle fed babies are they release a large amount of the stress hormone cortisol into their systems, when this happens regularly their brains develop permanent life-long patterns of increased cortisol release, this is very strongly associated with depression, heart disease and autoimmune disease in adulthood. Therefore it could be said medically breastfeeding is safer long -term as it is usually done 'on demand' (in response to crying). Another idea would be to adopt this demand feeding with bottle fed babies and also to avoid the controlled crying technique though it may be impractical to have to make many smaller bottles and waste would be greater (Palmer, 2008).
Breast milk and mimics almost all its nutritional properties. Scientists plan to eventually market this milk and promote it as a best option than cows' milk. It could be said, however, that we do not drink breast milk as adults for a reason. The World Health Organization recommends exclusive breastfeeding for the first six months of life but after this; other foods are needed to provide us with our nutrition. Parents are told not to introduce cows' milk until their child is 12 months old because they cannot tolerate the proteins but one doctor goes on to say that nobody should drink cows' milk as it is not suitable for humans at all and he welcomes this new development. Many experts are angry with this 'violation'. It has been said that scientists genetically modified embryos by crossing them with human genes then implanting them into surrogate cows.
There are many problems that are associated with breastfeeding, in some cases these outweigh the benefits, while naturally it takes time to get used to breastfeeding, sometimes engorgement, excessively leaky breasts, sore, cracked, bleeding nipples, or mastitis mean that bottle feeding could become favoured or safer option (Baby Centre, 2011)
Smoking mothers pass on nicotine to their baby; if a mother cannot give up entirely it is best to smoke just after a feed as the nicotine levels will be lower again by the next feed: it may be healthier for a smoking mother to bottle feed so she is not passing dangerous chemicals onto her baby.
Thrush is a fungal infection that can get passed back and forth between the mother and baby at feed (Cassidy, 2011).
A mother diagnosed with breast cancer should not breastfeed her infant as prolactin levels remain high during lactation and these stimulate further growth of the cancer. In cases of mothers who are addicted to drugs and unable to keep their own bodies healthy, it makes sense that bottle feeding should not only be encouraged but mandated but this could be an opening for control on women who smoke, drink or eat unhealthily (Sullivan, 2004)
There is such a wide range of formula available and it could become confusing for a new mother. Pre-term formulas have recently added DHA( decosahexaenoic acid) to make it more like pre-term breast milk but they cannot add things like mothers' live cells or antibodies. Weight gain in infants varies greatly depending on which formula is consumed however linear growth is not; babies on cow's milk formula overfeed in nearly every study whereas babies on protein hydrotsysate (containing pre-digested proteins) formula did not. Cow’s milk proteins are large and difficult for a baby to digest, a high percentage of babies develop allergies to the proteins in cow's milk, even if passed through from breast milk. One expert suggestion to avoid this is to put all babies on hypoallergenic formula from the beginning, as even when the dairy intolerance is not visible commonly it is detected and leads to anaemia. Many mothers are told they should feed this way, but it could be a much better idea to continue breastfeeding and simply the mother to avoid in her diet (Mennella, 2010).
A solution to the common occurrence of the stomach upset and colic in Formula fed babies would be to provide them with a powered version of pro- biotic creating a friendlier environment in there. Formula companies are currently studying the addition of pro-biotic in their milks (Palmar ,2008).Concern has been raised about all this exposure to non – human protein sources and powder based breast milk fortifier ‘Prolacta’ a formula company , have developed human – sourced liquid fortifier and firmly all infant nutritional products should be human milk based (prolacta ,2012). In the telegraph (Hopkinson ,2007) one mother spoke of finding her blood in her baby’s mouth at feeds due to such cracked nipples . In report it states that although exclusive breastfeeding is re recommended for the isrt six months of life by the World Health Organization (WHO) in reality studies how no baby is fed this way. This NHS feeding survey of 2005 states that 76% of woman started breastfeeding , but within six weeks , 52% of those women had given up . Some woman with blocked pores w ere even told to stick sterilized needles into their won nipples causing all sorts of pain and damage. For some women the determination to do what is best for their baby has cost them £1000’s on breast pumps, help and counseling and they have ended up being treated for depression. Can this really can ‘best’ for baby? Also untreated mastitis can lead to a breast abscess needing surgery.
There have been reports that pre-term and soya based formula milk in the UK has extremely high levels of aluminum and these levels are still too high even after the formula companies were told to decrease levels as it is linked to disease. The impact of such levels is being argued between the companies' researchers and pediatricians (Exley, 2010).
In conclusion it can be said that breast milk is best. It is agreed that, an infant's stomach cannot handle cow's milk protein and breast milk offers a good protection to the gut; especially in premature babies, meaning this is an issue that makes breast milk necessarily the only good option. Scientists are continuing to gain a better understanding of the chemistry and function of breast milk.
The public have been informed as formula in many cases has been portrayed as potentially dangerous to a child, this exaggeration is insulting to many mothers who have tried but failed to breastfeed or who cannot, or choose not to breastfeed due to ethical or practical reasons.
One could say the strongest argument for encouraging mothers in developed countries to breastfeed is ecological and environmental; breast milk is free there are no costs (including environmental ones) as associated with production or purchasing bottles and equipment and no worries about the energy consumed in all the sterilization needed. Breastfeeding is the best medical option in developing countries as they are unable to maintain the necessary levels of hygiene and the water quality is low. Breast milk has been shown to be the best fluid for premature babies.
Whilst breastfeeding can be seen as an all-round best option for babies and is strongly supported: the facts about breast mean we can also support those who make an informed choice not to breastfeed, in this country they are not doing their baby any harm. For some it is inconvenient to their home or work situation; babies are better off with a happy mother however they are fed. Facts are that maternity regulations allow a mother to breastfeed according to recommendations if she must return to work.
Nature intended babies to breastfeed with the good quality of breast milk. Breast is for a child's overall health and will guarantee a permanently thin, beautiful, healthy, intelligent child because it has all essential nutrients.
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Accessed on 30 June 2012
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References in Support of Katherine Dettwyler’s Work
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