Pediatric researchers at the University of California, San Francisco, have just discovered something that anthropologists (and moms around the world) have known for years. You do not have to go all or nothing on breast-feeding in the very beginning in order to breast-feed successfully long term.
In fact, a new paper in the journal Pediatrics has found that early limited formula feeding actually increases the rate of long-term exclusive breast-feeding. The difference was quite dramatic. A total of 79% of 3-month-old infants who received early supplementation were being breast-fed exclusively, while only 42% of babies who received no supplements were still being exclusively breast-fed at 3 months old. The study involved only a small number of infants, all of whom were losing weight at a rapid rate as newborns, but the findings may have implications for all breast-feeding mothers.
Breast-feeding activists have long argued that supplementation is detrimental to breast-feeding. It is a position that has been codified in the Baby-Friendly Hospital Initiative (“Give infants no food or drink other than breast milk, unless medically indicated”) and programs like New York City’s Latch on NYC, which goes so far as to lock up formula as if it were a dangerous drug.
What’s interesting to note is the fact that many other cultures — some with much higher breast-feeding rates than ours — infants are given other liquids until a mother’s milk comes in. According to a review of 25 previously published studies of tens of thousands of mother-infants pairs in such countries as India, China, Nigeria and Saudi Arabia, a significant portion of women (from 25% to 50%) delayed breast-feeding for an average of 66 hours. Many of these infants received supplemental fluids, some of which are even imputed to have ritual significance.
One of the greatest barriers to breast-feeding in this country is the unreasonable expectations set by breast-feeding advocates. They are loathe to admit that many babies may benefit from supplementation in the first days after birth, that some babies will require more milk than their mothers produce, and that many mothers must return to work within weeks and simply cannot breast-feed exclusively. Instead of acknowledging those realities, they have alienated new mothers with their all-or-nothing approach, leaving most women to figure out a method of combining breast and formula feeding that works for them on their own.
According to the most recent numbers available from the Centers for Disease Control and Prevention, about 25% of breast-fed children are given supplemental formula in the first two days of the child’s life, 37% of breast-fed children are given supplemental formula by 3 months and 43% by 6 months of age. Those are some large numbers, and yet women who combine breast-feeding with any formula at all are basically anathema to the lactation police.
The Pediatrics study is both small and preliminary, but the results accord with breast-feeding practices both around the world and in our own backyard. It’s time to put what we know to good use to stop making women feel guilty about combining breast-feeding and supplementation if that’s what works for her baby and herself.