The Right to Breastfeed Act

Wisconsin could soon become the forty-second state to legalize breastfeeding in public. State Sen. Fred Risser, D-Madison, and Rep. Sheldon Wasserman, D-Milwaukee, authored "The Right to Breastfeed Act" after being contacted by a supporting constituent who had a negative experience while breastfeeding in public in a shopping mall.

An article by Julie Sherman on the AssociatedContent.com site titled Legislation Proposed to Protect a Woman's Right to Breastfeed in Public gave details:

This law, should the bill pass, will protect a mother's right to feed her infant anywhere, and will include punishment for those who choose to harass or discriminate against that right. "If a person was harassing a woman who was breastfeeding, she now - if this bill passes - would have a legal right to complain and that individual would be arrested and fined," Risser said. If found in violation of this law, the punishment would be a $200 fine.

This particular bill is modeled after the laws in 30 states, and seem long overdue. "Babies deserve the best nutrition they can get, anytime or anywhere they want it." said co-author Wasserman. I hope few will disagree with that.

Don't Water Down Baby Formulas

Here's a sad and frightening article, Too much water not good for infants by Dan Kelly of the Reading Eagle.

A Florida woman brought her infant son, unconscious and convulsing, into the St. Petersburg Hospital emergency room.

The diagnosis: Water intoxication.

The mother told doctors she had been adding water to her infant's formula to conserve the powder.

"Basically, babies do not need water," said Dr. Mary Ann Mancano, chairwoman of St. Joseph Medical Center's pediatrics department. "The side effects of too much water go all the way to seizures, coma and death."

The Johns Hopkins Hospital issued a warning that, if a baby is given too much water over time, the child will become malnourished and underweight. Symptoms may include irritability or sluggishness; their face may swell and their eyes may flutter hours before the child goes into convulsions.

This is a dismal side effect of the current recession. Desperate parents try to make every food stretch and can unwittingly do their children harm.

The article makes the good point that breastfeeding is cheaper than formula and always healthier than watered-down formula could ever be.

"Chemicals" In Breastmilk: A Primer

Lactoferrin. Lysozyme. Endocannabinoids. The next time you read a scare article about the "chemicals" we're putting into our babies, think of this: somebody near where you live, probably right down your street, is pouring these particular chemicals into the bodies of the most vulnerable humans. Infants. Newborn babies.

Who's doing this horrible thing?

Nursing mothers. All those chemicals are important components of human breastmilk. (Lactoferrin binds to iron, boosting iron uptake and taking it away from invading bacteria and fungi who require it. Lysosyme works with lactoferrin to attack the cell walls of some bacteria. Endocannabinoids stimulate suckling and appetite.)

Here's another myth you can throw out, the perfectness of breastmilk. It can be deadly. "For every six months that an HIV-positive women breastfeeds, there is about a 4 per cent chance of the infant becoming infected. Despite this low infection rate, it's estimated that breastfeeding is responsible for up to half of the 640,000 HIV infections in infants each year."

Of course, only those who believe in every silly and ignorant internet article on milk, written by people who not only have no knowledge of science, but fear what they don't understand, subscribe to myths like those. Intelligent people, like my readers, know that when you see an article decrying "chemicals" in food, you can stop reading immediately without any worries that you might be missing some useful information. And they know that despite the risks, exclusive breastfeeding for at least six months is still the greatest single gift a mother can give her infant.

Too few mothers, even in the western world, breastfeed exclusively for six months, however. "[I]n the US, just 11 per cent of babies are exclusively breastfed up to the age of six months. In the UK, the figure is just 3 per cent." Mothers in developing nations face widespread beliefs that formulas are somehow better than breastmilk for infants, even though contaminated water supplies mean that formula-fed babies can be six times more likely to die in the first two months.

All these quotes and statistics come from an important article in New Scientist magazine, Making formula milk more like mum's, by Jo Whelan, from the July 14, 2008 issue.

Whelan's overall point is that while persuading mothers to breastfeed is crucial, the worldwide lack of consistent breastfeeding means that improving baby formulas so that they more closely resemble breastmilk will also save many lives and produce far healthier infants and adults in the long term.

Yet even that is subject to the very fears about science that produce the idiot myths that already infest the internet. Better formula will depend on duplicating the kind of human proteins that include the "chemicals" I mentioned in the first paragraph and many others. Today this is such a difficult and expensive bit of technology that nobody in the third world could expect to see any of them. Few wealthy Americans could even afford this enhanced formula.

There is one possible source:

The only way to mass-produce human proteins is to genetically engineer other organisms to make them, and plants are emerging as the most practical option. At least seven human milk proteins have already been produced in modified food crops, mainly potatoes and rice, with more in the pipeline. The leading company in this area is Ventria Biosciences of Sacramento, California. It is growing rice in Kansas which contains human milk proteins which, it hopes, can be added to infant formula and oral rehydration salts.

Rice is particularly attractive, as it rarely causes allergies in humans and is often used as a weaning food. However, several giant agribusiness and food companies have protested at Ventria's plans. The fear is that these transgenic crops could end up in our food chain.

Yep, it's the "dread" genetic engineering raising its head again, threatening to give babies healthier food. Because of the fearmongering that already exists, it's unlikely that any of these proteins will be created this way in any foreseeable future.

I certainly can't guarantee that these proteins, these techniques, these innovations are the absolute right way to proceed. Nobody can say that about any advance, made by any means. In a world in which tomatoes, er, I mean jalapeños, may be dangerous, or thought to be dangerous, or may at some time in the future prove to be dangerous, people are suspicious of everything even while demanding and devouring new and unfamiliar foods every day.

In a world with food shortages leading to riots, with crops being taken out of the food supply to turn into fuel, with obesity at an epidemic in westernized countries, with people being gulled and duped by flagrantly ignorant advice about diet, nutrition, and food, we need more understanding, innovation, and productivity and far less fear and nonsense.

Breastfeeding Rates Up in U.S.

All major physician, nursing, and health groups recommend breastfeeding for all mothers who are able to do so. Most studies also show that breastfeeding can play a major role in decreasing the likelihood or severity of dairy allergies in infants with family histories of allergies.

So it is very good news to learn that a variety of studies have shown that breastfeeding rates are up across the board in the U.S. over the past 20 years, according to the Centers for Disease Control and Prevention (CDC).

Mike Stobbe reported the numbers in the Seattle Times.

About 77 percent of new mothers breast-feed, at least briefly, the Centers for Disease Control and Prevention said.

"It looks like it is an all-time high" based on CDC surveys since the mid-1980s, said Jeff Lancashire, a CDC spokesman.

Experts attributed the rise to education campaigns that emphasize that breast milk is better than formula at protecting babies against disease and childhood obesity. A changing culture that accommodates nursing mothers may also be a factor.

The percentage of black infants who were ever breast-fed rose most dramatically, to 65 percent. Only 36 percent were ever breast-fed in 1993-1994, the new study found.

For whites, the figure rose to 79 percent, from 62 percent. For Mexican-Americans, it increased to 80 percent, from 67 percent.

...

At least three types of CDC surveys have shown breast-feeding rates moving upward since the early 1990s, officials said.

The latest CDC report found rates of breast-feeding were also lowest among women who are unmarried, poor, rural, younger than 20, and have a high school education or less.

New Breastfeeding Study Gives Mixed Allergy Results

On September 12, I posted Exclusive Breastfeeding Doesn't Reduce Asthma or Skin Allergy Risk. In it I talked about the results from a large study of breastfeeding mothers that said:

Children who were exclusively breastfed for at least the first three months of life were no less likely to develop allergies or asthma than children whose nutrition included infant formulas.

This week a second breastfeeding study, of an even larger group of mothers, was published in the Journal of Allergy and Clinical Immunology. "Breast-feeding and atopic disease: A cohort study from childhood to middle age," by Melanie Claire Matheson et al. The abstract says:

Methods
The Tasmanian Asthma Study is a population-based prospective cohort study that has followed participants from the age of 7 to 44 years. Exclusive breast-feeding in the first 3 months of life was examined as a risk factor for atopic diseases by using multiple logistic regression and generalized estimating equation analyses.

Conclusion
Exclusively breast-fed babies with a maternal history of atopy were less likely to develop asthma before the age of 7 years, but more likely to develop asthma after the age of 7 years.

A press release quotes the study's lead author on the implications:

Dr Matheson said the research confirmed the current recommendations that high risk infants – those whose mothers had an allergy – should be exclusively breast-fed to protect against wheezing illness in small children.

However, recommendations that babies be exclusively breastfed to protect against asthma and allergy in the long term should be reconsidered.

Dr Matheson said further investigation was needed to determine why there was an increased risk of developing asthma after seven years of age.

"It could be that mothers are passing antibodies on to their babies or because of increased hygiene and reduced exposure to infections early in life," she said.

"The breastfed children in our study had fewer bacterial and viral infections, were more likely to be first born and in a higher social class – these all factors related to increased hygiene."

Dr Matheson said the study’s authors acknowledged there were many benefits of breastfeeding and were not suggesting that women with allergies should not breastfeed.

"However, if you are concerned about preventing allergy in your children, it may be more effective to implement other strategies such as not having carpet in your home," she said.

The study, a collaboration between the University of Melbourne, Monash University and the Menzies Research Institute in Tasmania, used data from more than 8500 people from the 36 year follow-up of the Tasmanian Longitudinal Health Study. It is the first in the world to follow subjects from childhood into middle age.

However, the study was almost immediately attacked by the Australian Breastfeeding Association in a release titled "Breastfeeding and allergy study flawed".

The question that needs to be asked is - how exclusive was the breastfeeding? The studied group of people were all born in 1961. Giving every newborn baby a nightly feed of artificial formula was routine in the 1960s. This was often without the mother's permission or knowledge. One exposure to non-human milk can sensitise a baby's immature gut and make them more prone to allergies.

...

According to the Australian Breastfeeding Association (ABA), there is nothing in this study to justify calling for any changes to the recommendations on breastfeeding. The causes of allergy and asthma are complex. Breastfeeding mothers should be reassured that one study is not a reason to ignore a large body of evidence that shows breastfeeding is the best way to feed an infant.

In the short term, I agree with the ABA's conclusion. Even the study's author continues to recommend that high-risk infants be exclusively breastfed.

It is possible, even likely, that the connection between breastfeeding and allergies after the age of 7 will turn out to be a statistical fluke rather than an accurate prediction. Both sides of the argument agree that more studies are needed. The Tasmanian study may be the first of its kind and vitally important for that reason alone, but as I always emphasize, one study, even a good one, is not sufficient to force people to change their practices unless the risks are immediate and severe. These are neither.

I'll keep an eye out for follow-up.

A "Breastfeeding-Friendly" Environment, with Dairy-Free Options

The U.S. is apparently not the only country in which otherwise sane adults grow hysterical at the site of a women breastfeeding her baby. New Zealand has the same problem.

Cure? A "breastfeeding-friendly" environment.

Adam Long started Koffee Kulture after women had been told not to breastfeed in other upscale cafés.

According to an article by Andy Hay on the New Zealand Herald website:

As well as allowing mothers to feed anywhere in the café, it provides a breastfeeding booth, so a mother can feed baby in private and keep an eye on siblings in the play area, Long says.

The café also offers gluten and dairy-free options, hosts a pram walking group and holds "bouncy castle days".

Other parent and child-friendly cafés have been popping up all over New Zealand as well.

Good for them. It's a trend we need to import.

Exclusive Breastfeeding Doesn't Reduce Asthma or Skin Allergy Risk

The word from doctors has always been that breastfeeding - exclusive breastfeeding, with no use of formula - is the best way to reduce the risk of babies developing later allergies.

That may still be true for dairy allergies, but the risk of asthma, hay fever, or eczema was not reduced at all by exclusive breastfeeding for the first three months of live, according to a new study in the journal BMJ.

An article by Peggy Peck on MedpageToday.com has more details.

Children who were exclusively breastfed for at least the first three months of life were no less likely to develop allergies or asthma than children whose nutrition included infant formulas.

Moreover, by age six, children who were nourished solely by breast milk had a two- to threefold higher risk for positive skin prick tests for four of five antigens, Michael S. Kramer, M.D., and colleagues from Montreal Children's Hospital reported in the Sept. 12 issue of BMJ.

...

For allergic symptoms and diagnosis there was "borderline significant reductions in history of eczema both with more prolonged any breastfeeding and with more prolonged exclusive breastfeeding (P=0.08 for both associations)."


However, the strongest associations were for skin prick tests and those went "in the opposite direction," said the researchers, with significant increased risk for positive tests among children who had exclusive breastfeeding for six months or longer.

However, there were some indicators that went the other way.

For allergic symptoms and diagnosis there was "borderline significant reductions in history of eczema both with more prolonged any breastfeeding and with more prolonged exclusive breastfeeding (P=0.08 for both associations)."

Since this study did not look at dairy protein based allergies, presumably exclusive breastfeeding is still the best route to lower future risk. However, this is an interesting finding that will certainly generate more studies.

Answers to Questions from Readers, part 8

Q.a. Some years ago a doctor told me citrus fruits contain milk sugar, which experience tells me is the case. Is this information well known? I have never seen any reference to it in the literature.

Q.b. A girlfriend who is LI claims that chicken contains lactose and causes the exact same symptoms for her as a nice big glass of milk. I think she's whacked. Is she?

a. This information is missing from the literature because there is no foundation to it. Milk sugar is found in milk and nowhere else in nature. The sugar in citrus fruits is fructose.

b. You bet she is. Lactose comes from milk. Period. But people with LI often have problems with other foods and confuse the symptoms.

Q. If I take lactose pills or lactose-reduced milk, is this depriving the baby of any needed nutrients during pregnancy or breastfeeding?

Absolutely not. All that happens is that the lactose, the sugar in milk, is broken down to its parts. This is exactly what occurs in digestion. Your body gets exactly the other nutrients it would otherwise get.

If lactase pills work for you, then take them as often as needed. If you are still bothered by symptoms, then you may want to try less milk and either increase your consumption of other foods high in calcium or take calcium supplements. But LI will be the least of your concerns.

Q. Other than cost, is there a problem with using lactase tablets at every meal (or every lunch)? Is there a limit on how many one should take?

No problems and no limits, although after the first few you're probably not going to get much additional help by taking more.

For more information on everything lactase, see the Lactase page in the LI Basics section of my web site.

Q. Is burping a symptom of LI?

Not normally. The gas almost always comes out the other end. You should have your doctor look at stomach-related problems rather than intestine-related problems like LI.

Q. I'm at the end of my first week of eating no dairy products to see if I am LI. Can I simplify this work a bit and assume that if the nutrition breakdown shows 0% calcium, that there is no lactose in the product?

Nope, sorry. Lactose is milk sugar. It has absolutely nothing to do with calcium.

The only way to tell whether a product is lactose free is to study the ingredients list and make sure that there are no milk products on it. If you aren't sure what all the names for milk products are (and many people don't know that whey is mostly lactose) you should check the Dairy Facts section of my web site and take a look at the various pages there.

Fewer Mothers Breastfeed for Six Months

The weekly Morbidity and Mortality Weekly Report put out by The Centers for Disease Control and Prevention does not make for light reading.

The topics covered are still of crucial interest to those that they concern, and the current week has one that has widespread interest indeed, Breastfeeding Trends and Updated National Health Objectives for Exclusive Breastfeeding --- United States, Birth Years 2000--2004.

Fortunately, I can let the Associated Press summarize it for us.

Nearly three-quarters of new U.S. mothers are breastfeeding their babies, but they are quitting too soon and resorting to infant formula too often, federal health officials said Thursday.

A government survey found that only about 30 percent of new mothers were feeding their babies breast milk alone three months after birth. At six months, only 11 percent were breastfeeding exclusively.

Formula is not as good at protecting babies against diseases, eczema and childhood obesity. Ideally, nearly all mothers should breastfeed their babies for six months or more, said David Paige, a Johns Hopkins University reproductive health expert.

...

The CDC study found that rates of exclusive breastfeeding were lowest among black women and among those who were unmarried, poor, rural, younger than 20, and had a high school education or less. Those findings are consistent with earlier studies.

This year the government announced goals for 2010: getting 60 percent of women to breastfeed exclusively for the first three months and 25 percent through six months.

Breastfeeding is generally acknowledged to be particularly helpful in immunizing infants against dairy allergies. Mothers who do breastfeed the full six months recommended find that they children suffer less from dairy allergy symptoms.

Which is also a call for people to drop their opposition to breastfeeding in public. You can actually find those whose justify their opposition by saying that while breastfeeding may be natural, so is pissing and shitting, and nobody wants to see you do that in public.

The equation of a beautiful and life-giving bounty with the elimination of waste says much more about the psyches of the opponents that anything about breastfeeding. It must be terribly dark and disturbed inside their brains, frighteningly so.

Please support breastfeeding. Make it easier for women to do so. Allow them the space and freedom to do it at work. Stop embarrassing them by harassing them in public. End the sometimes all too literal old wives' tales about the havoc breastfeeding supposedly wreaks on breasts. Breastfeeding will create healthier babies and that's good for them and for everyone else in the long run.

Breastfeeding: Any Time, Any Place, It's Still Good

Breastfeeding is a subject that seems to drive people insane. Despite my public stance of encouraging breastfeeding for any woman who is able to do so, I've been attacked by fanatics because I also give advice on formulas to women who can't or even won't breastfeed. For some women, breastfeeding is an absolute. All women should do it. I'm not sure what they're supposed to do with their baby if they can't. Give it for adoption, I suppose. This is apparently a position equivalent to that of abstinence for sex education. There is an enormous amount of proof that abstinence doesn't work as a policy, but that matters not to its advocates. Better to have a failed, unworkable, counterproductive policy than change one's mind.

Did you know that 38 U.S. states have laws stating that women have the basic right to breastfeed in public? I don't know why the other 12 don't. Perhaps it's too obvious for them to bother with.

Yet the fanatics persist. Breastfeeding, they say, is obscene. Horrid. Indecent. (Twenty-three states have exempted breastfeeding from any violation of their indecency laws.) A photo of actress Maggie Gyllenhaal breastfeeding her child started an uproar. Here's another photo of her doing so, less blurry than the original.



Are you properly shuddering in horror? Why not? You can clearly the entire side... of her baby's head.

Don't believe me that breastfeeding is sickening? Check out this letter from a woman - a woman, mind you - writing in to the Dear Amy advice column to say that:

I am as uncomfortable knowing that a woman is breastfeeding even if the mother is wearing a tent, as I would be with a couple groping each other with all their clothes on. It just isn't public entertainment.

Well, no, it isn't. It's a function vital to the health of babies. All children should be breastfed for at least the first six months. It doesn't happen. No more than about 30% of American women do so.

In a Newsweek article Karen Springen wrote:

Even formula makers say "breast is best." Nursing reduces a baby's risk of diarrhea, ear infections, urinary-tract infections and bacterial infections (and perhaps food allergies, obesity and diabetes). It also lowers a mom's risk of breast and ovarian cancer—and, since it burns 500 calories a day, helps her lose weight. And it's free, while formula costs about $1,500 a year.

Look, the human body is not obscene. Nudity by itself is nothing special. It can't harm anyone, even children. Breastfeeding was witnessed by children and adults for the first 99,900 of humanity's 100,000 years of existence without corrupting anyone, slowing down progress, disrupting morals and ethics, or contributing to blindness.

It is time to put these antiquated notions about the human body in the same cultural trashcan as putting coverings on piano legs so as not to offend someone's delicate sensibilities. Encouraging breastfeeding is as valuable and as productive as encouraging energy conservation. Sorry, I forgot that that's controversial too.

When American society gets into these fits of collective insanity, the only thing to do is shock it back to its senses. If you run into those who object to a mother's discreet breastfeeding of her child, shout "nipples" at them at the top of your lungs. See if they get the message.