More Thoughts On Breastfeeding & Vaccination

July 10th, 2007 · 20 Comments
Vaccines · breastfeeding

This post was prompted by a discussion on breastfeeding over at PI’s blog, which in turn was inspired by commentary on this post at Pointlessly Hypertechnical. There are also connections to comments made in an earlier discussion on my blog.

Breastfeeding, when successful, is the best source of nutrition for an infant’s health, and I encourage every mother to breastfeed in accordance with the recommendations from the American Academy of Pediatrics (exclusive breastfeeding for the first 6 months of life). Along with being a nutritionally complete and balanced food source, breast milk also contains maternal antibodies that protect infants from many childhood infections. That immunological benefit will never be replicated by formula because it’s just too cost prohibitive.

However, I recognize that breastfeeding is a challenge in today’s stressful, fast-paced world. I think Diane Vespa did a good job on PI’s site outlining the reasons for this. For moms in financially secure families who have a good support system and are able to stay at home with their children, it’s relatively easy to breastfeed. That same task becomes nearly impossible for an impoverished single working mom with zero support other than brief visits to her pediatrician. Some moms in that situation still manage it (to my amazement), but we shouldn’t make mothers who are already stressed and struggling to support their children feel like failures because they can’t sustain breastfeeding. There can also be medical and/or psychological issues that make it impossible for a mother to nurse, so we shouldn’t be overly judgmental.

In this country most children do fine on formula, although there are risks. Constipation is a relatively common problem with formula-fed infants that’s almost non-existent in breastfed children. There is some evidence suggesting links between formula feeding and increased risk for obesity, high cholesterol, SIDS, asthma, diabetes (both type 1 and type 2) and even leukemia & lymphoma (the AAP Policy Statement contains links to the various studies if you’re interested).

However, these increased risks with formula vs. breastfeeding are all very small, and all require further study and confirmation. While the short-term benefits vs. infection are clear, there are just too many confounding variables to link these long-term protective effects definitively, no matter how fervently breastfeeding supporters wish to do so. If you eat Super-Sized Combo Meals from your local fast food joint for every meal, it doesn’t matter whether you were breastfed or formula fed as an infant – you’re going to become obese.

Formula does carry the risk of triggering allergic sensitivity to the cow protein in the formula, but that can also occur in breastfed children if the mother consumes dairy products. Sometimes milk protein allergy can be so severe that children require elemental formula or even IV nutrition for part of their lives. Fortunately this severe allergy is quite rare. It’s also often true that children who have THAT strong of an allergic tendency will be become atopic no matter what they’re fed as an infant, although earlier sensitization does make things worse.

There are also times when breastfeeding is not a good idea. In countries where clean drinking water is readily available, HIV positive mothers absolutely should not breastfeed. There is a significant risk that they will pass the virus to their infant. In developing countries this risk is outweighed by the risk of death from dysentery because the formula is reconstituted with contaminated water, but that’s not the case here in the United States.

I’ve also seen one case where the infant of a Vegan breastfeeding mom ended up in the pediatric intensive care unit at 9 months old with failure to thrive and cerebral edema due to severe malnutrition, profound iron-deficiency anemia requiring multiple transfusions and severe rickets (bone demineralization and malformation from vitamin D deficiency). These cases are quite rare, but it does happen.

Breastfeeding isn’t for everyone, and its protective effect on a child’s immune system is certainly NOT an adequate substitute for childhood vaccination. It frustrates me that many of the same folks that are militantly pro-breastfeeding are often also militantly anti-vaccination. I support both breastfeeding and vaccination, but if I had to choose between one or the other, then I would choose vaccination any day of the week.

Some obviously don’t agree with that choice, but I think the 300-500 million people killed by smallpox in the first 77 years of the 20th century would agree with me. They can’t, of course … because they’re dead.

I think the 20,000 afflicted with congenital rubella syndrome during the last large-scale rubella epidemic in the U.S. would also agree with me. Of course they couldn’t understand the discussion … because they’re mentally retarded, blind and deaf.

I think the 10-20 million people worldwide permanently disabled by polio would also agree with me … but then again, some wouldn’t hear my query over the noise of their iron lung.

The victims of vaccination’s lack are quite effectively silenced, and our cultural memory of these horrible epidemics is rapidly fading. Vaccination has become a victim of its own success.

Then again, you shouldn’t listen to me. My soul has been sold for a $55 copy of the Harriet Lane Handbook and a few carry-out lunches provided to me by the companies that sell formula and vaccines. I’m utterly corrupted.

20 responses so far ↓

1 diane vespa // Jul 10, 2007 at 10:48 pm

Hey Knight, thanks for the honorable mention. Although I had to chuckle at this comment “itâ€™s relatively easy to breastfeed”… ha ha… its obvious, on more than one level, that you have never tried to breastfeed! LOL
2 knightindragonland // Jul 10, 2007 at 10:50 pm

I figured I’d get flack for that statement … which is why I italicized “relatively.” It’s almost never easy, especially the first time … but I think you knew what I meant.
3 Nemo // Jul 10, 2007 at 11:49 pm

WTF are you going on about Vaccination?
When did I say it was a bad thing?
I’m all for it.

Again, thanks for your continued attention…lol
4 PeoriaIllinoisan // Jul 11, 2007 at 8:20 am

Good post, Knight.
5 Julie // Jul 11, 2007 at 9:56 am

Nemo… how self absorbed you must be to think this is about you. Knight is a pediatrician. Not that that matters since he would know nothing on the topic of health of children.
6 Ms. PH // Jul 11, 2007 at 10:08 am

Knight — Thanks for the informative post about this issue. What I find interesting is that no one has talked about the history of breastfeeding in this country. The strong push for breastfeeding has only been a recent movement in the United States.

I was born in 1971 and I was exclusively breastfeed, but my mother was repeatedly harassed by other women and doctors who insisted formula feeding was better. At that time (and for many, many years before) breastfeeding was considered lower class in the United States – something only women without means to purchase formula did. It was not until the studies started support the benefits of breastfeeding that the tide changed.

My mother was born in Europe, where standards were much different and stuck to her guns when it came to breastfeeding me and my younger brother. Her mother was extremely supportive of the decision. On the other hand, her mother-in-law thought it was horrible. Why would an educated woman (who went back to work when I was 10 days old) waste her time breastfeeding? Thank goodness there is much more support for breastfeeding mothers today.

As I said on my own blog, I will not discuss the reasons I do not breastfeed in a public forum. I admire the parents who have shared their stories and support their decisions either way. It is nice to know that the vast majority support my decision as well.
7 Nemo // Jul 11, 2007 at 10:20 am

Julie,
Do you lack reading comprehension skills?
Read where he linked back to.
8 knightindragonland // Jul 11, 2007 at 10:33 am

My god you’re self-absorbed, Nemo. I linked back to the general conversations at PI’s and PH’s blogs, as well as a conversation here that had nothing to do with you. My only specific reference to you came under the heading of “overly judgmental.” If you’re proud of that attention … OooooooooK.
9 admin // Jul 11, 2007 at 2:51 pm

For God’s sake, Knight, stop using reason, science and history to support your position. This is obviously a debate over who REALLLLLLY lves their children and who doesn’t.
10 Michelle // Jul 11, 2007 at 3:58 pm

There are many, many different ways to parent. I have very strong opinions about how things should be done — and many of them aren’t at all mainstream. So I don’t want anybody making rules about what all parents should do, because my ideas would likely not ever be the ones chosen by the majority. But they worked extremely well for me, and when people are open to hearing my ideas, I’m happy to share them. It’s always been common for people to make positive comments about my children. They are old enough now (teens) to see that they’re turning out well in spite of my “wacky” ideas. One of my core beliefs is that my decision to practice what is sometimes called ecological mothering has made a profound difference and continues to make a difference in how my children have grown up. I don’t just mean that both kids have had only a couple of illnesses in their lives, either. The health advantages to breastfeeding are the least of its benefits. What is now called attachment parenting (but I just called doing what felt right to me) naturally led to other crazy ideas, like baby-wearing, positive discipline, child-led weaning, etc. It’s been like dominoes — one decision has quite naturally led to another, until today I have two teenagers who are turning out pretty darned well. I have a warm relationship with both of them. They don’t have the anger/resentment toward me that I had toward my parents as a teen. I might have to punish them once every couple of years. They love me and are just motivated to be good kids. I don’t mean they are perfect by any means — we do have issues with them keeping their bedrooms clean and things like that. But I don’t have problems with them lying, disobeying, showing disrespect, getting in trouble at school, or whatever. When I look back at the nearly 18 years I’ve been a mother, I have very few regrets, very few things I’d do differently. I would say that the best advice I could give any parent is to love your child with all your heart and to think seriously about what is best for your child — what really feels totally right in your heart — and to do it no matter what anybody else thinks. Too many people seem to just do whatever they see others do. It’s hard for me to imagine that for some people, bottlefeeding (especially bottle propping), spanking, letting babies cry it out, feeding toddlers lots of goldfish crackers and other junk all day, etc. etc. would feel absolutely 100 percent right to them, but I do recognize that that’s the “normal” way to raise babies in our culture. So I don’t know whether that really and truly feels right to others in their heart, or if they are not following their hearts for some reason. I’m just thankful that nobody had the right to keep me from raising my children the way that I as their mother knew was best for them. I’ve enjoyed every stage of mothering, from newborns and toddlers to teenagers. I’m not an especially religious person in the traditional sense, but to me, raising children is a truly spiritual experience. I just wish I was young enough to have a few more.
11 Sue // Jul 11, 2007 at 5:11 pm

Extra! Extra! Read all about it…how come these people don’t breast feed their kids?

Dude pulls a knife on Wal-Mart employee while stealing baby formula
March 26th, 2007 Â· No Comments
If I didnâ€™t have too many categories on this blog as it is, Iâ€™d make a new one just for Wal-Mart Baby Formula Theft. A dude named Angel Ortega tried to swipe some baby formula from a Hartford, Connecticut Wal-Mart and got caught, but he apparently didnâ€™t want to go quietly. He pulled a knife on a worker and took off in his own car, then ditched it and stole a PT Cruiser. Cops finally caught him and slapped him with fifteen charges. (NBC30.com)

Wednesday Jun 27

Mom left baby alone, stole baby formula

Bay City News

A Redwood City woman was sentenced to a month in jail Tuesday for leaving her infant home alone in March while she pillaged a local Target store for more than $600 worth of baby formula, according to the San Mateo County District Attorney’s Office.

Kamara Vasilakos, 25, pleaded no contest in San Mateo County Superior Court in April to felony grand theft and misdemeanor child endangerment after getting caught stealing $620 worth of baby formula from a Redwood City Target store on March 25.

Vasilakos reportedly told police she left her 8-month-old child at home with another family member while her husband was at softball practice, but a welfare check found the baby alone, crying in the crib, according to the district attorney’s office.

A subsequent investigation revealed that Vasilakos “had been on a binge of stealing baby formula and diapers” and then selling them on Craigslist, the district attorney’s office reported.

A judge sentenced Vasilakos to three years of probation and 30 days in county jail. She was ordered to report to jail on Aug. 11.

Man who assaulted Wal-Mart greeter and stole baby formula . . . does it again!
February 19th, 2007 Â· No Comments
The difference this time? They caught the freak. Cops say that Viet Thai Nguyen is the dude who tried to leave a Vaughan, Candada Wal-Mart with a cart full of baby formula, then broke a female greeterâ€™s nose when she tried to stop him. This moron apparently returned to the scene of the crime a few days later to double-dip, but this time he was caught by store security trying to steal another cart full of formula.

Nguyen assaulted yet another Wal-Mart employee in the process of nabbing him, but this time he didnâ€™t get away. Now heâ€™s facing two counts of robbery, assault and possession of stolen property. (Toronto Star)

Had my giggle so I went and googled (.)^(.)
12 Nemo // Jul 11, 2007 at 5:42 pm

I love this.
Formula Feeding promotes crime.
Thanks for the laugh
13 Sue // Jul 11, 2007 at 6:56 pm

Gees Nemo…you really have “fish brains”! I’ll bet you’re the one sending those death threat emails
14 Just A Girl // Jul 12, 2007 at 8:43 am

I appreciate the views of your latest blog…even if it is written by a man (hehe…I hate that argument!) .

I’m what I think Michelle would call a “normal” mom of an almost two year old. I think it’s odd that the way I parent has been refered to as what society accepts. When it comes to mom’s my age in mid to upper class famlies (those I’m friends with) attachement parenting is the way to be!

It’s true. My friends “wore” their children while doing everything! Mine rolled around the floor. My friends have children who from an early age practiced their ABCs, listen to Mozart, and look at pictures painted by famous artists. My child at an early age was subjected to the TV (gasp!) and reacted more to Motown than Mozart. My friends breastfed/breastfeed their children to the point (if not past) their children being able to ask for it. I had a goal of breastfeeding till my child drank for a cup and had to settle to getting to 3 months old. Many of my friends got to stay at home with their children for an extended amount of time, I had to go back to work at the end of my leave. My friends research all vaccinations, some didn’t have their children vaccinated. I took my child in without blinking an eye.

I won’t go into whos child did what first and the temperment our children have. What I will say is our children have all developed at a very normal pace and seem to be smart and healthy children.

I agree with Michelle, the key is to do what feels right. To me it didn’t feel right to be a mom who did baby wearing. In fact, it didn’t feel right to do many things my friends were doing, and sometimes it still doesn’t. What does feel right is loving my child the best way I know how and that included formula, vaccinations, The Doodlebops, dressing up in hats and beads while dancing around the house to the Temptations, and yes…the occasional baggie with Goldfish crackers.
15 Gloria // Jul 12, 2007 at 11:01 am

Thoughts on breastfeeding:

If you have breasts, and if you have a hungry baby,then this is your business.
Otherwise, shut up.
16 Gloria // Jul 12, 2007 at 11:03 am

Another thought, this time on vaccination.
god gave us a way to prevent disease in our children – vaccination.
Kind of a no-brainer, isn’t it?
17 Jeannie Grys // Jul 17, 2007 at 11:10 pm

Ok, as usual a day late and a dollar short, but my question is, about the people stealing formula. Geeze, can’t feel sorry for them, yea they might be poor, yea, they might have a hungry baby, but I am sorry….#1 I don’t know about Knight, but I can assure you that if I called Dr. Tosi and said, hey my baby is hungry and I am broke, that his nurses would give me bags of formula samples. #2. virtually anybody can qualify for WIC which is FREE FORMULA so, IMHO if you steal formula, it is not because your baby is starving because you are poor. It is because you are to lazy to get the formula that is available.

BTW, Some of us (me) breastfed and had babies that ended up classified failure to thrive. Other’s (my sister) breastfed and had a 9mo old that could not get a 24 mo shirt buttoned around her fat neck! The baby had fat rolls on her arms that looked like rubber bands were around them! Honest to goodness my sis produced cream that separated! And I had watered down skim milk! LOL we discussed shaking them up in a blender to get a more even consistancy for our kids, but the dads questioned that brilliant idea. So my poor children had to thrive on formula. To each his own!!!
18 heather // Dec 26, 2007 at 10:45 am

Just a reply to the lady who said “god gave us a way to protect our children- vaccination” Are you seroius?? God gave us an immune system. People mixing toxic and harmful chemicals in a lab gave us vaccinations!!! Stop feeding your children crap all the time and breastfeed them to build a strong healthy immune system and you wont need those awful chemicals injected into your helpless baby!!!
19 Renata // Dec 27, 2007 at 9:49 am

Yeah for Heather! Our immune systems rock. These diseases don’t kill anymore unless you are undernourished as was the case in the 1800’s and early 1900’s. People had enough money to buy bread, potatoes, rice. Try eating that every day and you’ll catch any disease that passes by and may even die from it. The only cases of polio in the last 40 years have been from catching polio from the oral polio vaccine which has since been changed. My boys caught mumps and whooping cough overseas, no big deal. It is all about money. America thrives on money. Whether it be harmful street drugs, harmful pharmaceutical drugs, warmongering, imperialism, gas prices, vaccinations, formula, McDonalds, c-sections, epidurals. It is all about money, not health. We are all suckers and slaves. Fight for your health! Keep your money.
20 Knight in Dragonland // Dec 27, 2007 at 4:52 pm

I’ll be sure to tell the 300,000 people (mostly children) who died from measles last year that they’re not really dead, Renata.

BTW, my practice LOSES money by providing vaccinations for my patients. That’s true of many pediatric practices, but they continue to provide this service because it’s the most effective method of disease prevention available. Vaccines are the number two expense for pediatric practices after staff salary. Insurance companies only pay for the cost of the vaccine and a minuscule administration fee. Some practices, at best, manage to break even.

How does that fit into your neat little paranoid fantasy world?

The only cases of polio in the last 40 years have been from catching polio from the oral polio vaccine which has since been changed.

Yes, the polio vaccine has been changed in recent years because there were a few (although still exceedingly rare) cases of poliomyelitis caused by the vaccine strain of the oral polio vaccine (OPV). The inactivated polio vaccine (IPV), while not as effective as OPV, does not carry that risk. Since there have been very few cases of polio in the Western hemisphere (although there have been a few cases among recent immigrants from endemic areas), IPV was considered adequate coverage.

Why is the incidence of polio so rare in the Western hemisphere? VACCINATION. Your moronic and convoluted logic REQUIRES the success of vaccination to perpetuate your delusions that the human immune system is adequate defense against all infectious disease. Your dangerously fallacious ideas would unleash devastating plagues upon us all, returning us to a time when childhood was the most dangerous period in our lives that many did not survive.