Breastfeeding

Straight From the Mama's Mouth: Advice on Fussy / Gassy Babies

Very often women bring up gassy / fussy baby issues on Beautiful Breastfeeding's Facebook page (Natural Mama NZ's sister site). Mothers pour in with helpful advice, sharing what has worked for them personally. For me this is the best advice and it's one of crowning achievements of motherhood support pages on Facebook. Because gassy / fussy baby  issues keep coming up on Beautiful Breastfeeding and other motherhood pages I thought I'd collate some of the great advice shared through various threads into a blog post. Enjoy...

Check the Latch
"Have you had your latch checked? It's more likely a latch issue than a milk issue; if your latch is slightly off he may be swallowing large amounts of air and he will get very uncomfortable from this."

Burp More Often
"Burp your baby mid-feed. Makes a world of difference with gassy barfy babies."
"Burp more throughout day not just around feedings. Also try burping before feeds. Check out Dunstan baby language."

Try Different Positions
"If you walk around with them tummy down on your forearm, head resting in the nook of your arm. I found this position helped them get through it. And sucking makes their guts move so nurse him. Even if he’s fighting it and cranky...it will help it move through."
"Holding upright after feeding helps, as does gas drops and gripe water. The best thing I've found are what I call “fartercise”. Bicycling wasn't enough I have to gently stretch his legs up until his feet touch his face. GENTLY I stress. And I start with knees bent and gentle pressure towards his tummy and work my way up. It was the only way I could get him some relief. Now he giggles the whole time I do it but as he's getting older he is able to take care of most of it himself."
"I had gassiness / fussiness problems with my daughter, what I did was to hold her up for an hour or more after each breast feed! Now she's two months and she is better, baby needs time to adjust with everything."

 Baby Massage
"Before cycling baby’s legs get some lotion and do the "I love you" massage (google it) and instead of doing JUST his legs lift his body up and slowly roll it back down, like you would do if you were stretching your back. Doing that gets so much more gas out."
"Along with bicycling baby's legs, I would do infant massage on tummy. Worked like a charm with mine."

Babywearing
"Carrying in a sling/wrap close to you is worth trying."
"My little guy had similar issues, so I would burp him after 10 min or so. I also wore him everywhere, and the movement helped him a lot. In the Moby wrap I would bounce-walk and it would calm him down when he was screaming in pain."
"I wear my baby in a Sleepywrap for most of the day and he is so comfortable, he just sleeps, and wakes when he's hungry."

Probiotics
"You can give your baby their own probiotics. It's the only thing that helped my daughter when she had gassiness / fussiness around the same age. We used BioGaia."
"Probiotics helped my son so much. We used Flora Baby."
"I give my baby probiotics! Works great! You can get it at any health food store!"
"You can buy Florajen probiotics for baby." 
"I highly recommend probiotics for your baby too! I started giving them to my baby girl when she was 8 weeks for gassiness / fussiness and they worked very fast. I've been giving them to her ever since and she's never had any GI problems. They're very good for immunity and overall health (I've been working on probiotic research in different diseases for the last 8 years). Hope he feels better soon!"

Change Your Diet
"Could be what you are eating... when I made some changes in my diet I saw a wonderful improvement in my baby."
"Write down what eat! I found out I can't have pepperoni at all my daughter gets gas and stomach ache so bad."
"I chose to cut out many things and it works for me. Some are ok with onions, garlic, soy, dairy, gassy veggies, corn and red meat, some are not. In order to know, you have to cut it out COMPLETELY for a couple of weeks."
"I had to cut all dairy and gluten and it made a HUGE difference."
"My youngest had an issue with me consuming any caffeine."
"Hot sauce hurt my little guy's tummy too."
"What about broccoli? Gave mine gas something fierce."
"I had to eliminate caffeine, peppers, and dairy from my diet."
"Cutting out dairy and other "gassy" foods completely was the only thing that helped us. My baby did grow out of it by about three months except for large amounts of dairy. Goodluck!"
"Try the elimination diet. It takes at least 3 weeks of total elimination from your diet for diary to get out of your system and see results that are consistent."
"If diary is the problem ALL dairy has to be avoided if it is supposed to work. Any dairy will elicit an adverse response in an infant that is allergic or sensitive to dairy (even hidden diary like casein). Same goes for soy and wheat. Please read this: http://kellymom.com/health/baby-health/food-sensitivity/ Also, if you consider cutting dairy altogether, this list may be helpful: http://www.godairyfree.org/dairy.../dairy-ingredient-list-2 See also here: http://kellymom.com/parenting/parenting-faq/gassybaby/ Take care x"
"Have you tried cutting all soy out of your diet? Could be egg allergy, too."
"Watch the onions, garlic, peppers, beans, broccoli and cabbage. I know it's tricky getting your feet on solid ground, but you will get there! And it's SO worth it!"
"Gluten could definitely be a culprit. Cut gluten containing foods front your diet (pay as much as you can attention to all products labels, it can hide anywhere) just for few days and see what' s new in his status. Take care!"
"Watch out for certain seasonings too. All I can eat is salt on my food. Only veggies are corn and squash too. It's worth it as no screaming baby! Oh and no soy either, even soy oil or lecithin... which is in chocolate!"
"My daughter was like this and it turns out she is cows milk protein intolerant. This meant I couldn't have any dairy or soya in my diet - none at all. It takes a month to get out of your system so you have to be patient, but it definitely worked for us. She's now 20 months and still has a dairy and soya free diet. Could be worth a try."

Foremilk / Hindmilk Imbalance
"What are his poops like? If green and lettuce like, you may have a foremilk/hind milk imbalance....baby may not be getting the full day milk that comes toward the end of a feeding session."
"It may be a foremilk and hindmilk imbalance, try to make sure he feeds at least 25 mins both sides. Lots of good energy, you can do it!"
"We had this issue ourselves! For us it had nothing to do with what we were eating, or when I breastfed. My baby was getting too much of the start of the breast milk that is like skim milk, and not enough of the cream at the end of the feeding. If this is your issue, feed on one side until that breast is completely empty. Even if the baby stops because it's full, start again on that same side the next time until it is empty. This way the baby gets all the digestive enzymes that are in the thicker milk to help them digest the skim. We fixed that problem in 24 hours doing that. We sure had a lot of crap advice to the contrary though. Hang in there!"
"How long is your baby nursing on one side?...If he is a quick nurser he could be getting too much foremilk. Foremilk has a lot of lactose in it when that lactose mixes with his little intestines it is painful. And creates a colicky acting baby. Try nursing on one side for a block if time. Each time in that block baby nurses go to the same side, don't switch. When the block is over do the same on the other side. Good luck!"
"Try feeding on one side only. My little guy was getting horrible gas from too much foremilk. Once I started nursing him on just one side it helped tremendously. I pumped out the other to keep my supply up. Around eight weeks it all changes a lot anyway. Stick it out mama! You're doing a great job!"

Forceful Letdown
"When my daughter had that problem our issue ended up being my letdown was too much for her to handle and caused her to take in air. We switched nursing positions to one where she sat upright while nursing and this worked out great for us."

Reflux
"It may be reflux. My son has it. He just takes reflux medication and keeps on breastfeeding."
"You could ask your doctor to give you acid reflux meds and if the problem is reflux it will all go away within days. It worked for all 3 of my children. After weeks of crying with my first. Acid reflux is common in children whether breastfed or bottle fed. So if the problem is reflux, changing to formula will not fix this problem at all, the baby will still be fussy and upset."
"Might be acid reflux, try Ranitidine. Get it from your doc. That is what my baby had and it worked. He had the same symptoms."

It Gets Better With Time
"Time will solve it, some babies are gassy and colicky but this won't last forever!
Don’t give up because it is just a stage!"
"My pediatrician said baby’s guts "wake up" at around 4-6 weeks and they are just fussy and gassy for a little while."
"Some babies might just have a rougher time getting their digestion up and running smoothly. Baby will make it promise."
"Gas starts going away around 2 months old. My baby just smiles and farts now when it was so bad at first."
"We went through gassiness / fussiness with my daughter (now nearly 8mo). It was a rough 6 weeks but after that she was much better."
"ALL my babies (4) went and are going (3weeks old) through a period of gassiness / fussiness. I honestly think it is just their guts adjusting to life on the outside. I nursed them all until after 2 years old including my 21 month old I am still nursing along with the 3 week old."
"Both my babies always seemed in pain with gas, grunted, cried, and struggled...but breast feeding helped them push through it. It does and will pass as he grows, it may seem like it takes them forever to do so, but it will happen. Keep on breast feeding!"
"It will go away, mine went through a gassy phase at 6 weeks and it was gone around 8 weeks or so."
"My son had colic for the first three months of his life. He was our first baby and it broke our hearts to see him in such pain. He cried constantly and so did I. Everyone I knew (and didn't know) commented on his colic and many insisted I switch to formula. I refused and nursed him for the first three years of his life. I have absolutely no regrets about this decision. He was a very high needs baby who was and still is super sensitive but today he is an amazing 5 year old."
"I nursed, held and wore him constantly as a baby and I truly believe this attachment parenting created the foundation for a remarkable and confident young boy. Good luck to you, follow your heart and try to remain positive. His colic will decrease with age and you too can experience an incredible relationship together particularly with breast feeding."
"Both my babies were gassy in the beginning. What I can say is that by 12 weeks it disappeared completely, it's just that until then their tummies are incapable of digesting properly. Hang in there, I promise it passes."

Medication
"They say breastfed babies don't get colic but mine did, it was awful, but once we started colic drops it settled down."
"Baby Gerber Colic Drops. I didn’t believe in it til I tried the drops."
"Simethicone is good - it gathers all the air in the tummy just ingested with a feed, and it all gets burped up in one glorious burp! After a day of this, the colic settles down a lot as those tiny air bubbles never made it into the intestines. My son is 12 weeks and had a lot of colic. I started giving him simethicone a few weeks ago and it's made a difference."
"Mylicon works for my son."
"I had to give my baby Levsin (Hyoscyamine) and it worked wonders!"
"I used to use Infacol drops before each feed which helped."
"My baby was really gassy the first month or so too. I used the target brand gas drops. It worked better than the gripe water. And it tastes way better."
"Colief definitely."
"Try Little Remedies: Little Tummies. Both of my kids used it."
"My son is 7 weeks old and went through this the first 6 weeks. He has reflux and now is on a PPI medication and I give him gas drops Colic Calm he is a whole different baby! It’s truly trial and error! good luck momma!"
"I got stuff called Colic Calm at Walgreens and I'll tell you what IT WORKS! Invest in some!
"Try a product called Iberogast it's an amazing herbal product that is great for wind, colic and reflux."
"My son was very gassy and the only thing that worked was Ovol."
My daughter responded well to a little chamomile tea! I'd breastfeed then give her a couple tablespoons of tea...big burp, big fart and she was happy. Good luck mama" 
"Try cooled fennel tea or homeopathic chamomilla. My boy was the same and they really helped. Health food shops stock chamomilla granules especially for tiny ones."
"My baby had issues with gas and my pediatrician suggested an ounce of prune juice mixed with an ounce of water once a day. Helped my little guy out tons!"
"Buy some carroway seeds and make a tea out of it, you and the baby should drink some, it will help the gas get out!"

Check For Anatomical Problems
"Just make sure that your baby does not have lip or tongue tie that would cause the baby to have a poor latch and get more air when eating. Look at www.kiddsteeth.com to get information about how to check. If you think this is a problem, you can PM me. Good luck! This probably isn't the issue, but I just wanted you to rule it out because it does affect 3-5% of babies."

Chiropractic Care
"My son was diagnosed with GERD and given Zantac. It helped for a few months but he started presenting similar symptoms again. We took him to a chiropractor that diagnosed him with a hiatal hernia. He's been so much better ever since! I suggest looking into a reputable chiropractor that works on infants. And they don't adjust infants the same as adults. My son was on my lap the entire time. Good luck!"
"Chiropractor works miracles for babies! Highly recommend, we dealt with the same issue with my youngest and nothing else helped but the chiropractor. Good luck!"

Try to Avoid Formula
"Worst possible idea is to switch to formula - it will only make things worse as formula is a lot harder on an infant's gut than breast milk. Even just a bottle can cause severe damage to the natural Ph level of his gut. My son was the same, very colicky. I just persisted and he is now 5 months, still breastfeeding and very happy! Don't supplement his milk with anything, and just hang in there. http://www.health-e-learning.com/articles/JustOneBottle.pdf"
"Formula actually gave my daughter much worse gas."
"We tried formula and it made no difference with gas! Only made him constipated."

Helpful Books
"It may have nothing to do with his stomach or the milk. Colic is not always caused by stomach issues. My baby had colic for the first 4.5 months and it was so difficult but I was given a book called "Happiest Baby on the Block". Seriously this book is a must read for mothers of colicky or fussy babies, it saved our sanity. He will grow out of it and the book gives real solutions for calming him in the meantime that work. Good luck and don't give up yet."

Bottlefeeding

Watch Your Language


By Diane Wiessinger, MS, IBCLC

The lactation consultant says:
You have the best chance to provide your baby with the best possible start in life, through the special bond of breastfeeding. The wonderful advantages to you and your baby will last a lifetime.
And then the mother bottlefeeds. Why?

In part because that sales pitch could just as easily have come from a commercial baby milk pamphlet. When our phrasing and that of the baby milk industry are interchangeable, one of us is going about it wrong...and it probably isn't the multinationals. Here is some of the language that I think subverts our good intentions every time we use it.

Best possible, ideal, optimal, perfect.
Are you the best possible parent? Is your home life ideal? Do you provide optimal meals? Of course not. Those are admirable goals, not minimum standards. Let's rephrase. Is your parenting inadequate? Is your home life subnormal? Do you provide deficient meals? Now it hurts. You may not expect to be far above normal, but you certainly don't want to be below normal.

When we (and the artificial milk manufacturers) say that breastfeeding is the best possible way to feed babies because it provides their ideal food, perfectly balanced for optimal infant nutrition, the logical response is, "So what?" Our own experience tells us that optimal is not necessary. Normal is fine, and implied in this language is the absolute normalcy--and thus safety and adequacy--of artificial feeding. The truth is, breastfeeding is nothing more than normal. Artificial feeding, which is neither the same nor superior, is therefore deficient, incomplete, and inferior. Those are difficult words, but they have an appropriate place in our vocabulary.

Advantages.
When we talk about the advantages of breastfeeding--the "lower rates" of cancer, the "reduced risk" of allergies, the "enhanced" bonding, the "stronger" immune system--we reinforce bottlefeeding yet again as the accepted, acceptable norm.

Health comparisons use a biological, not cultural, norm, whether the deviation is harmful or helpful. Smokers have higher rates of illness; increasing prenatal folic acid may reduce fetal defects. Because breastfeeding is the biological norm, breastfed babies are not "healthier;" artificially-fed babies are ill more often and more seriously. Breastfed babies do not "smell better;" artificial feeding results in an abnormal and unpleasant odor that reflects problems in an infant's gut. We cannot expect to create a breastfeeding culture if we do not insist on a breastfeeding model of health in both our language and our literature.

We must not let inverted phrasing by the media and by our peers go unchallenged. When we fail to describe the hazards of artificial feeding, we deprive mothers of crucial decision-making information. The mother having difficulty with breastfeeding may not seek help just to achieve a "special bonus;" but she may clamor for help if she knows how much she and her baby stand to lose. She is less likely to use artificial milk just "to get him used to a bottle" if she knows that the contents of that bottle cause harm.

Nowhere is the comfortable illusion of bottlefed normalcy more carefully preserved than in discussions of cognitive development. When I ask groups of health professionals if they are familiar with the study on parental smoking and IQ (1), someone always tells me that the children of smoking mothers had "lower IQs." When I ask about the study of premature infants fed either human milk or artificial milk (2), someone always knows that the breastmilk-fed babies were "smarter." I have never seen either study presented any other way by the media--or even by the authors themselves. Even health professionals are shocked when I rephrase the results using breastfeeding as the norm: the artificially-fed children, like children of smokers, had lower IQs.

Inverting reality becomes even more misleading when we use percentages, because the numbers change depending on what we choose as our standard. If B is 3/4 of A, then a is 4/3 of B. Choose A as the standard, and B is 25% less. Choose B as the standard, and A is 33 1/3% more. Thus, if an item costing 100 units is put on sale for "25% less,"the price becomes 75. When the sale is over, and the item is marked back up, it must be marked up 33 1/3% to get the price up to 100. Those same figures appear in a recent study (3), which found a "25% decrease" in breast cancer rates among women who were breastfed as infants. Restated using breastfed health as the norm, there was a 33-1/3% increase in breast cancer rates among women who were artificially fed. Imagine the different impact those two statements would have on the public.

Special.
"Breastfeeding is a special relationship." "Set up a special nursing corner." In or family, special meals take extra time. Special occasions mean extra work. Special is nice, but it is complicated, it is not an ongoing part of life, and it is not something we want to do very often. For most women, nursing must fit easily into a busy life--and, of course, it does. "Special" is weaning advice, not breastfeeding advice.

Breastfeeding is best; artificial milk is second best.
Not according to the World Health Organization. Its hierarchy is: 1) breastfeeding; 2) the mother's own milk expressed and given to her child some other way; 3) the milk of another human mother; and 4) artificial milk feeds (4). We need to keep this clear in our own minds and make it clear to others. "The next best thing to mother herself" comes from a breast, not from a can. The free sample perched so enticingly on the shelf at the doctor's office is only the fourth best solution to breastfeeding problems.

There is a need for standard formula in some situations. Only because we do not have human milk banks. The person who needs additional blood does not turn to a fourth-rate substitute; there are blood banks that provide human blood for human beings. He does not need to have a special illness to qualify. All he needs is a personal shortage of blood. Yet only those infants who cannot tolerate fourth best are privileged enough to receive third best. I wonder what will happen when a relatively inexpensive commercial blood is designed that carries a substantially higher health risk than donor blood. Who will be considered unimportant enough to receive it? When we find ourselves using artificial milk with a client, let's remind her and her health care providers that banked human milk ought to be available. Milk banks are more likely to become part of our culture if they first become part of our language.

We do not want to make bottlefeeding mothers feel guilty.
Guilt is a concept that many women embrace automatically, even when they know that circumstances are truly beyond their control. (My mother has been known to apologize for the weather.)

Women's (nearly) automatic assumption of guilt is evident in their responses to this scenario: Suppose you have taken a class in aerodynamics. You have also seen pilots fly planes. Now, imagine that you are the passenger in a two-seat plane. The pilot has a heart attack, and it is up to you to fly the plane. You crash. Do you feel guilty?

The males I asked responded, "No. Knowing about aerodynamics doesn't mean you can fly an airplane." "No, because I would have done my best." "No. I might feel really bad about the plane and pilot, but I wouldn't feel guilty." "No. Planes are complicated to fly, even if you've seen someone do it." What did the females say? "I wouldn't feel guilty about the plane, but I might about the pilot because there was a slight chance that I could have managed to land that plane." "Yes, because I'm very hard on myself about my mistakes. Feeling bad and feeling guilty are all mixed up for me." "Yes, I mean, of course. I know I shouldn't, but I probably would." "Did I kill someone else? If I didn't kill anyone else, then I don't feel guilty." Note the phrases "my mistakes," "I know I shouldn't," and "Did I kill anyone?" for an event over which these women would have had no control!

The mother who opts not to breastfeed, or who does not do so as long as she planned, is doing the best she can with the resources at hand. She may have had the standard "breast is best" spiel (the course in aerodynamics) and she may have seen a few mothers nursing at the mall (like watching the pilot on the plane's overhead screen). That is clearly not enough information or training. But she may still feel guilty. She's female.

Most of us have seen well-informed mothers struggle unsuccessfully to establish breastfeeding, and turn to bottlefeeding with a sense of acceptance because they know they did their best. And we have seen less well-informed mothers later rage against a system that did not give them the resources they later discovered they needed. Help a mother who says she feels guilty to analyze her feelings, and you may uncover a very different emotion. Someone long ago handed these mothers the word "guilt." It is the wrong word.

Try this on: You have been crippled in a serious accident. Your physicians and physical therapists explain that learning to walk again would involve months of extremely painful and difficult work with no guarantee of success. They help you adjust to life in a wheelchair, and support you through the difficulties that result. Twenty years later, when your legs have withered beyond all hope, you meet someone whose accident matched your own. "It was difficult," she says. "It was three months of sheer hell. But I've been walking every since." Would you feel guilty?

Women to whom I posed this scenario told me they would feel angry, betrayed, cheated. They would wish they could do it over with better information. They would feel regret for opportunities lost. Some of the women said they would feel guilty for not having sought out more opinions, for not having persevered in the absence of information and support. But gender-engendered guilt aside, we do not feel guilty about having been deprived of a pleasure. The mother who does not breastfeed impairs her own health, increases the difficulty and expense of infant and child rearing, and dismisses one of life's most delightful relationships. She has lost something basic to her own well-being. What image of the satisfactions of breastfeeding do we convey when we use the word "guilt"?

Let's rephrase, using the words women themselves gave me: "We don't want to make bottlefeeding mothers feel angry. We don't want to make them feel betrayed. We don't want to make them feel cheated." Peel back the layered implications of "we don't want to make them feel guilty," and you will find a system trying to cover its own tracks. It is not trying to protect her. It is trying to protect itself. Let's level with mothers, support them when breastfeeding doesn't work, and help them move beyond this inaccurate and ineffective word.


Pros and cons, advantages and disadvantages.
Breastfeeding is a straight-forward health issue, not one of two equivalent choices. "One disadvantage of not smoking is that you are more likely to find secondhand smoke annoying. One advantage of smoking is that it can contribute to weight loss." The real issue is differential morbidity and mortality. The rest--whether we are talking about tobacco or commercial baby milks--is just smoke.

One maternity center uses a "balanced" approach on an "infant feeding preference card" (5) that lists odorless stools and a return of the uterus to its normal size on the five lines of breastfeeding advantages. (Does this mean the bottlefeeding mother's uterus never returns to normal?) Leaking breasts and an inability to see how much the baby is getting are included on the four lines of disadvantages. A formula-feeding advantage is that some mothers find it "less inhibiting and embarrassing." The maternity facility reported good acceptance by the pediatric medical staff and no marked change in the rates of breastfeeding or bottlefeeding. That is not surprising. The information is not substantially different from the "balanced" lists that the artificial milk salesmen have peddled for years. It is probably an even better sales pitch because it now carries very clear hospital endorsement. "Fully informed," the mother now feels confident making a life-long health decision based on relative diaper smells and the amount of skin that shows during feedings.

Why do the commercial baby milk companies offer pro and con lists that acknowledge some of their product's shortcomings? Because any "balanced" approach that is presented in a heavily biased culture automatically supports the bias. If A and B are nearly equivalent, and if more than 90% of mothers ultimately choose B, as mothers in the United States do (according to an unpublished 1992 Mothers' Survey by Ross Laboratories that indicated fewer than 10% of U.S. mothers nursing at a year), it makes sense to follow the majority. If there were an important difference, surely the health profession would make a point of staying out of the decision-making process. It is the parents' choice to make. True. But deliberately stepping out of the process implies that the "balanced" list was accurate. In a recent issue of Parenting magazine, a pediatrician comments, "When I first visit a new mother in the hospital, I ask, 'Are you breastfeeding or bottlefeeding?' If she says she is going to bottlefeed, I nod and move on to my next questions. Supporting new parents means supporting them in whatever choices they make; you don't march in postpartum and tell someone she's making a terrible mistake, depriving herself and her child." (6)

Yet if a woman announced to her doctor, midway through a routine physical examination, that she took up smoking a few days earlier, the physician would make sure she understood the hazards, reasoning that now was the easiest time for her to change her mind. It is hypocritical and irresponsible to take a clear position on smoking and "let parents decide" about breastfeeding without first making sure of their information base. Life choices are always the individual's to make. That does not mean his or her information sources should be mute, nor that the parents who opt for bottlefeeding should be denied information that might prompt a different decision with a subsequent child.

Breastfeeding.
Most other mammals never even see their own milk, and I doubt that any other mammalian mother deliberately "feeds" her young by basing her nursing intervals on what she infers the baby's hunger level to be. Nursing quiets her young and no doubt feels good. We are the only mammal that consciously uses nursing to transfer calories...and we're the only mammal that has chronic trouble making that transfer.

Women may say they "breastfed" for three months, but they usually say they "nursed" for three years. Easy, long-term breastfeeding involves forgetting about the "breast" and the "feeding" (and the duration, and the interval, and the transmission of the right nutrients in the right amounts, and the difference between nutritive and non-nutritive suckling needs, all of which form the focus of artificial milk pamphlets) and focusing instead on the relationship. Let's all tell mothers that we hope they won't "breastfeed"--that the real joys and satisfactions of the experience begin when they stop "breastfeeding" and start mothering at the breast.

All of us within the profession want breastfeeding to be our biological reference point. We want it to be the cultural norm; we want human milk to be made available to all human babies, regardless of other circumstances. A vital first step toward achieving those goals is within immediate reach of every one of us. All we have to do is...watch our language.

If you found this article of interest, you may desire to ensure you regularly receive your own copy of the Journal of Human Lactation(JHL). Taking out membership in the International Lactation Consultant Association(ILCA)includes the benefit of four issues of the JHL a year. See www.ilca.org for how to join.

Reprinted from the Journal of Human Lactation, Vol. 12, No. 1, 1996

References: 1. Olds D. L., Henderson, C. R. Tatelbaum, R.: Intellectual impairment in children of women who smoke cigarettes during pregnancy. Pediatrics 1994; 93:221-27.2. Lucas, A., Morley, R., Cole, T.J., Lister, G., Leeson-Payne, C.: Breast milk and subsequent intelligence quotient in children born preterm. Lancet 1992; 339 (8788): 261-64. 3. Fruedenheim, J.L., Graham, S., Laughlin, R., Vena, J.E., Bandera, E., et al: Exposure to breastmilk in infancy and the risk of breast cancer. Epidemiology 1994, 5:324-30. 4. UNICEF, WHO, UNESCO: Facts for Life: A Communication Challenge. New York: UNICEF 1989; p. 20. 5. Bowles, B.B., Leache, J., Starr, S., Foster, M.: Infant feeding preferences card. J Hum Lact 1993; 9: 256-58. 6. Klass, P.: Decent exposure. Parenting (May) 1994; 98-104. to kayhh's Breastfeeding page
Breastfeeding

Replies to: if they're old enough to ASK to nurse, they're too old to nurse

How many times have you heard this: if they're old enough to ASK to nurse, they're too old to nurse. As logically barren as this statement might be, I see it tossed around A LOT. When I saw it brought up in a Peaceful Parenting thread on Facebook I was so proud to read the responses from mothers nursing their toddlers, so I thought I'd collate some of best ones below.

"How do you respond to the whole, 'If they're old enough to ASK to nurse, they're too old to nurse...' criticism?"
Really? Why? What makes you say that? How do you know? Says who?
Do you mean if you can ask for it, you can't have it? 'It' meaning love, nutrition, comfort, nurturing, food, drink?
When my child can ask for broccoli by name, should I stop feeding it to him?
And if he is old enough to tell me he needs a diaper change I shouldn't do it?
Did you stop feeding your child when they were old enough to ask for food?
You're old enough to ask your waitress for food, should she not bring it to you then?
Just because we can communicate that we want something doesn't mean we don't deserve to have it.
Children have been asking to nurse since they were born! Language isn't always just spoken.
Children started asking at birth with the rooting reflex. The only difference now is that they use words.
In my family, children are to be seen, heard and believed. I know my child is done when he stops asking for it.
Meeting my child's needs now means that he won't have childish needs as an adult. If you baby the baby, you don't have to baby the adult.
And lastly, thanks for your concern. I will give it all the consideration it deserves.
I carry around a Kellymom article about extended breastfeeding in my diaper bag
The idea of carrying around some facts about extended breastfeeding (full term breastfeeding) is great. So you can quote things like this from Kellymom:
The biological weaning age of humans is 2.5 to 7 years of age.
Children weaned before two years of age are at increased risk of illness.
Nursing toddlers have fewer illnesses and illnesses of shorter duration.
Breast milk continues to provide substantial amounts of key nutrients well beyond the first year of life, especially protein, fat, and most vitamins.
Antibodies are abundant in human milk throughout lactation, and increase during the 2nd year.
Breastfeeding perks up children and energizes them; it soothes the frustrations, bumps and bruises, and daily stresses of early childhood. Nursing past infancy helps little ones make a gradual transition to childhood.
The WHO recommends breastfeeding for 2 years and beyond.
The American Academy of Pediatrics says:
It is recommended to breastfeed beyond 1 year and for as long as mutually desired by mother and child. There is no upper limit to the duration of breastfeeding. Increased duration of breastfeeding has significant health and developmental benefits for the child and the mother. There is no evidence of psychologic or developmental harm from breastfeeding into the third year of life or longer.
The longer a mother breastfeeds, the lower her risk of breast cancer, ovarian cancer, uterine cancer and endometrial cancer, osteoporosis, rheumatoid arthritis, and diabetes.
There is no evidence that nursing past infancy interferes with a child's appetite for other foods.
If you don't want to carry a sheet of facts, you can print out smaller info cards to keep in your handbag to dish out when needed (click to view a higher resolution version):




Here's a few articles with tips on how to deal with people's disapproval, questions or comments about breastfeeding past infancy:
How do I respond to and avoid criticism about breastfeeding?
Ask Dr. Sears: Extended Breastfeeding -- Handling the Criticism
Handling criticism about breastfeeding

A clip 'Ignorance Meets Knowledge (extended breastfeeding)' you can send to naysayers:


A clip of a typical mother and child (past infancy) breastfeeding:



Breastfeeding past infancy is not weird! It's normal, it's beautiful.

I'll leave you with one last light hearted comment from the Peaceful Parenting thread:
I'd squirt milk in their faces and chase them out yelling,"leave, leave this place now you mean terrible person". When I see these people again they honor me with gifts and say, "you are a goddess, liquid gold floweth from your body into your babe childs body, we have witnessed a miracle" I'd forgive them and bless them by annointing them with said liquid gold, upon their heads before leaving the room.
Bonding

Guest Post: Psychological benefits of breastfeeding and bonding

Painting by Alex Grey
http://alexgrey.com/
Written by Allison Gamble

In a world so full of scientific and technological advances, there are few things that are more natural than breastfeeding. This beautiful experience that is shared between mother and child has long been known for its many health benefits, but it doesn't take a psychology degree to see the benefits breastfeeding provides mentally. Despite the fact that there are a number of ways to bond with a child, breastfeeding has been proven to not only create a physical connection, but an emotional one as well.

Although the bonding process is said to begin in the womb, many women feel that the true psychological impact begins when skin to skin contact can be made. This impact is usually enforced by the frequent contact and interaction that occurs when a child is breastfed without restrictions or schedules. Though this almost constant contact can have a number of benefits for the child, for the mother, this contact creates a feeling not only of closeness with and affection for her child, but can serve to enhance her desire to be nurturing, and can also foster a feeling of confidence and accomplishment. After all, she is providing sustenance and good health to the life she has helped to create.

Despite the fact that many common psychological aspects are directly related to the physical contact that occurs during breastfeeding, many other mental and emotional responses can be directly linked to the release of hormones. For instance, in order for the milk to drop in the mother's breasts, a hormone known as oxytocin must be released into the system. Although this hormone acts in a number of ways to help the physical process of nursing, it also has a strong influence on emotions, often creating a general sense of well-being, happiness and love. Because of this, it is easy to link the child with this new-found feeling of contentment, and thus, the connection deepens.

Two other hormones that can benefit the psychological health of the mother are prolactin and cholecystokinin. Prolactin is best known as an aid in the production of breast milk. However, it is also thought to have an influence on maternal behavior, and in some animal studies, it is shown to act as a stress reducer and pain reliever. Like prolactin, cholecystokinin is thought to work as a pain reliever, but is also said to have a relaxing effect on both mother and baby. These three hormones work together in harmony, and because of this, mothers who breastfeed are thought to be generally calmer, have lower blood pressure, and are typically more responsive to their baby's needs and emotions.

Breastfeeding is undoubtedly favored by those seeking a more natural approach to child-rearing as it not only enhances the connection between mother and child, but also fits in well with other natural practices. For instance, mothers who breastfeed are more likely to practice co-sleeping. This particular process can further enhance the bond between both the mother and father, and the father and child, as sharing a family bed makes it much easier for the father to interact in an intimate manner with the child, and assist the mother in nursing. It may also aid in fostering feelings of attachment, emotional openness and trust across the entire family.

For babies, the psychological experience of breastfeeding is in many ways similar to that of the mother. For instance, skin to skin contact helps to provide the baby with a feeling of warmth and closeness. Additionally, this contact aids in the release of oxytocin, which in turn, gives the child the same feeling of contentment as the mother. Despite this, there are several psychological factors that differ from the mother. Many of these factors occur directly at the time of nursing, while others have a more long term effect.

In the early stages of the nursing process, while adjusting to the bright, loud external world, the intimacy of breastfeeding helps the child cope with the stress of its new life. It can also help to provide a feeling of safety, continuity and reassurance. Additionally, nursing can help the child to develop the simple feelings of attachment, love and affection through the natural bonding.

Long term effects are frequently the result of the tender experiences that go hand in hand with breastfeeding. In some research studies, it has been found that children who were breastfed were generally more likely to be assertive, confident and mature during their developmental years. Some reports suggest that, in the long term, breastfed children are less likely to develop behavioral, learning and psychological issues. These factors may be due in part to the chemical factors involved in breastfeeding; however, much of the credit can be given to the intimacy and bond that is created through the practice. For example, nursing allows the child to be given undivided attention, which may play a large part in the building of confidence. Mothers who breastfeed are more likely to talk to, hug and stroke their children while feeding, which may aid in the development of a sociable or affectionate nature later in life.

Aside from the numerous nutritional, economic and even societal benefits, nursing offers a natural way to improve the lives of children, mothers and families as a whole. From time immemorial, this nurturing, nourishing practice has been performed; however, in modern times it is beginning to fall by the wayside. Despite this, advocates of breastfeeding can feel secure in the fact that they are giving their children the best possible start in life – both in body and in mind.

Author Bio: Allison Gamble has been a curious student of psychology since high school. She brings her understanding of the mind to work in the weird world of internet marketing.
Breastfeeding

Breastfeeding Advocacy

Through the years I've talked to a lot of people about breastfeeding. I won't lie, there's been times I've made an ass of myself and turned people off breastfeeding rather than turning them on. But I've learnt better, thank god, and I hope others will join me in changing the way we advocate breastfeeding.

Do not say….

"Formula kills."
This just sounds over the top. Technically you could say formula 'kills' in certain circumstances (a severely allergic, ill, or immune compromised infant), but in the same vein you could say 'breastfeeding kills' in certain circumstances (a meth addict's infant recently died due to meth-tained breastmilk). The simple statement "formula kills" without any type of context is very leading and inflammatory. If you want to be taken seriously make realistic, detailed comments with specific context.

"Breastfeeding is normal and natural."
I know this seems like a rather true statement, and while it is true, it only tells us one side of the story. It does not tell the whole truth, the part that says for some of us breastfeeding doesn't always come naturally or feel normal – hours of pumping to produce tiny amounts of milk, or raw, bleeding cracked nipples does not feel normal or natural. When a woman encounters problems breastfeeding, as most women do, it entrenches the idea she has failed as a mother, and is neither normal or natural. A more realistic, inclusive statement would be: "Breastfeeding is the biological norm for our species, though in the beginning it is a major biological and lifestyle transition for any woman in which help is often needed, and in the rare occasion it is unsuccessful."

"Formula is disgusting crap in a can."
This statement is so belittling to a mother that relies on formula. For them this 'crap in a can' is a lifesaver. Formula isn't as healthy as breastmilk, but it serves its purpose. The above comment is a bit like saying a person in a coma living on nutrients through an IV is living on 'disgusting crap'. The IV isn't as good as eating a nutritious salad, but given the circumstances this person relies on it to stay alive.

People will often say, "but I'm not saying you're a bad mother for formula feeding, I'm just saying the formula is crap." But calling formula disgusting is not going to make them decide not to formula feed and switch to breastmilk, because they can't, they have no choice (or they believe they have no choice, when possibly there are options out there they just don't know about). Either way, calling the food they rely on to feed their infant "disgusting crap in a can" is simply going to make them upset or pissed off.

"Nine times out of ten women who say they can't breastfeed can, they just didn't try hard enough."
Where are the studies to back this up? Studies show the real reasons women stop breastfeeding are very different to "not trying hard enough". Here is an adapted excerpt from Dr Jane Philpott's blog, detailing the main points of why women don't breastfeed from a national UK survey…
A focus group study in the UK suggested a number of reasons why women may not breastfeed or why they stop breastfeeding early. These were as follows:
Worry about insufficient milk supply – this was the most common reason women stopped breastfeeding. Women worried that insufficient milk supply was causing poor weight gain, and said that health visitors were 'always worried about weight gain'. Women often interpreted an unsettled baby as an indication they had an insufficient milk supply.
Believing the child was old enough to wean – this was the second most common reason women stopped breastfeeding, being reported by 35.7% of women. However 78% of these women had stopped breastfeeding by 12 months, meaning these women were unaware that breastfeeding is recommended well beyond 12 months.
Physical or medical problem – this was the third most common reason women stopped breastfeeding. It was reported by 14.9% of women who did not breastfeed, and 26.9% of women who had breastfed, but had now stopped breastfeeding.
Society's negative attitudes towards breastfeeding - women felt that breastfeeding in public was unacceptable and embarrassing, while bottle-feeding was accepted by everybody and in all places. A lack of places to breastfeed out of sight restricted women's ability to get out of the house. This may be a bigger issue for low-income women, who may not have the option of breastfeeding in the car. Some women reported breastfeeding in public toilets as the only option. Women wished that cafés and shops could provide places to breastfeed with some privacy.
Influence of family and friends - some women said that even family and friends found it 'repulsive' to be in the same room when they were breastfeeding. Some grandparents thought it excluded them from having the chance to feed the new baby. It was clear that the opinion of family and friends was a stronger influence than that of health practitioners.
Lack of knowledge - women vaguely knew that breastfeeding was supposed to be beneficial, but they could not name any benefits, and were not convinced about them. In the study only one woman had learnt at school about benefits of breastfeeding; most did not hear about it until they were pregnant. Feeding was not well covered in antenatal classes.
Lack of professional support - women experienced difficulty in trying to establish breastfeeding but were unwilling 'to bother the midwife'. Bottle feeding seemed easier.
Experience - breastfeeding seemed difficult and painful, and many women experienced problems ranging from getting the baby latched on, sore nipples, and disturbed sleep. Some women complained of a lack of freedom to travel/socialise/work.


"Most formula feeding mums are just lazy and uninformed."
A great way to ostrasize and insult the people you are trying to win over.

Think of the formula feeding mothers who have visited numerous lactation consultants, pumped endlessly, suffered through raw bleeding nipples, were forced to work, face immense stressors in their lives, had no support, or suffer through severe post-natal depression. Yeah, they're going to think you're an asshole (because you are behaving like one). The reply I often hear is, "well I'm not talking about those women".

Yet even if a person is 'uninformed' or 'lazy' as some so eloquently put it, saying so is insulting, stereotyping, arrogant, and it's likely to make a person shut down rather than listen to you. Sharing anecdotal info about how you were once uninformed, and found great success in researching the benefits of breastfeeding, is a much more effective way to get your point across (while not being an asshole or pointing the finger).

"I'm not making you feel guilty, you make yourself feel guilty."
There is no debate some mothers who formula feed feel guilty. Some feel a sense of failure. Knowing this, in a conversation about formula or breastfeeding you've got to tread carefully, with respect, sensitivity and tact.

I didn't harbor guilt or failure when I formula fed, but I understand others do. There are experiences (such as not being able to produce enough milk) where I can't even pretend to know what it's like, and to pretend I do would be insulting to those that have been through it. I will say I hope mothers are able to one day realize that at any moment they are only ever doing the best they possibly can with the resources they have (be they health, info, finances etc). I hope they can be proud of all they have accomplished, and are able to let go of inadequacies others point out.

So how can we effectively help?
Based on studies about why women don't breastfeed, we need to offer specific info about…
  • Normal infant weight gain, checking whether baby is getting enough milk, the reasons why baby may be unsettled other than being hungry.
  • The importance of demand feeding, dangers of schedule feeding, the fact that newborns do need to feed often, the dangers of sabotaging breastmilk supply by supplementing babies diet with formula, and effective ways to build supply.
  • Recommended age to wean and the benefits of breastfeeding into toddlerhood.
  • Common medical problems associated with breastfeeding difficulty, prevention, and treatment.
  • Breastfeeding in public, women's rights to breastfeed in public, how to deal with rude commentors, specialized nursing clothing and covers women can wear if they wish.
  • How to deal with unsupportive family and friends, how to include them in caring for baby without negatively affective breastfeeding relationship, how to accept their opinions or advice about breastfeeding while keeping the advice of lactation consultants paramount.
  • The specific benefits of breastfeeding, provide studies to back up the benefits, and explain in detail the mechanisms by which breastfeeding is beneficial.
  • The necessity for lactation consultants, the stats showing how much more successful women who have professional support are. Provide local contact details, websites and prices.
  • The reality of what breastfeeding will be like, problems they may encounter, prevention & treatment, dealing with sore nipples, disturbed sleep, and incorporating travel, social life and work in with breastfeeding.

Watch how you word your comments, do say….
  • Realistic, detailed comments with a specific context.
  • Anecdotal stories of your own.
  • Reliable stats and studies with links.
  • Comments that respect others possible feelings of failure or guilt.
I know it's hard, but when you're in a discussion don't engage with angry commentors who are just out for a fight – don't take the bait! (You'll have to remind me.) If you do, your once revered comments may not get taken seriously anymore. 

For a little more reading...

Top 10 Things Breastfeeding Advocates Should Stop Saying
http://justwestofcrunchy.com/2011/05/27/top-10-things-breastfeeding-advocates-should-stop-saying/

Top 10 Things Breastfeeding Advocates SHOULD Say
http://justwestofcrunchy.com/2011/05/28/to-10-things-breastfeeding-advocates-should-say/

Thanks for Throwing Fuel on the Breastfeeding/Formula Feeding Fire
http://www.phdinparenting.com/2011/08/14/thanks-for-throwing-fuel-on-the-breastfeedingformula-fire/


Sources:

Why mothers don't breastfeed
http://drjanephilpott.wordpress.com/2009/03/27/why-mothers-dont-breastfeed/

Why primiparous mothers do not breastfeed in the United States: a national survey
http://onlinelibrary.wiley.com/doi/10.1111/j.1651-2227.2003.tb00501.x/abstract
Breastfeeding

Breastfeeding: Everyone's doing it!

I love seeing photos of other animals breastfeeding, giving birth, or looking after their babies. Makes me realise how rooted in nature we are. Here's a collection of some of my fav breastfeeding pics:





















Dog feeding baby red pandas

Dog feeding baby white tigers






Breastfeeding

Risks of Formula Feeding

Formula feeding is a touchy subject, but it's one that has to be addressed by parents. For some formula feeding remains a choice and for others circumstances dictate its necessity.

For parents researching the benefits/detriments of formula the most important fact I would want them to consider is that the rate of illness in formula fed infants is much higher than breastfed infants, especially the rate of infection. Breastmilk contains immunological properties that protect a breastfed infant from infection. Without this protection, a formula fed infant stands to have an abnormally high rate of illness throughout infancy. Below is a compilation of results from studies on the risks formula fed infants face.

I often get mothers saying, "Well I formula fed my infant and she's isn't sick all the time", or "I know a mother that exclusively breastfeeds her child and he's sick all the time". Figures like the ones below aren't saying that EVERY child that formula feeds will get sick, nor that every breastfed infant will be protected from illness, just that there is a much higher percentage  of  formula fed infants who do suffer these illnesses, compared to breastfed infants.

Almost all of the figures below have been adjusted for confounding factors, and are for developed countries such as the US and NZ, not developing countries.

Formula fed infants are…

5 times more likely to have more than 1 illness. 8
*compared to infants exclusively breastfed for 5 months.

16 times more likely to have 3 or more illnesses. 8
*compared to infants exclusively breastfed for 5 months.

5 times more likely to need hospitalization. 19
*compared to breast-fed babies for the first 6 months of life.

6 times more likely to be hospitalized due to infection. 19
*compared to breast-fed babies for the first 6 months of life.

5 times more likely to have gastrointestinal illness. 10
*when compared to infants exclusively breastfed for the first 13 weeks of life.
*any infection of the digestive tract caused by bacteria, viruses, or parasites.

4 times more likely to have necrotising enterocolitis. 14
*compared to preterm infants who received donor human milk.
*necrotising enterocolitis is a condition where portions of the bowel undergo tissue death, it has a death rate of 20-30%.

4 times more likely to have diarrhoeal disease. 27
*compared to infants breastfed for 6 months or more.

4 times more likely to be hospitalized for lower respiratory tract diseases. 16
* compared to infants breastfeed for 4 or more months
* lower respiratory tract diseases include bronchiolitis, asthma, bronchitis, pneumonia, empyema, and infections due to specific agents (eg, respiratory syncytial virus).

4 times more likely to have pneumococcal disease. 26
*compared to breastfed infants.
*pneumococcal disease is a bacterial infection that can present as pneumonia, bacteremia, meningitis, middle ear infection, and sinusitis.

3 times more likely to have ear infections. 11
* compared to infants exclusively breastfed for six months.

2 times more likely to have conjunctivitis. 11
* compared to exclusively breastfed for six months.

85% more likely to have urinary tract infections. 11
* compared to exclusively breastfed for six months.

7 times more likely to have thrush. 11
* compared to infants exclusively breastfed for six months.

93% more likely to have from type 1 diabetes. 22
*compared to breastfed infants.

60% more likely to develop type 2 diabetes later in life. 24
*compared to breastfed infants.

80% more likely to develop a wheeze during the first 3 years of life. 7
*compared to breastfed infants.

63% more likely to develop asthma during their first 8 years of life. 4
*compared to children breastfed for more than 4 months.

60% more likely to have visible dermatitis. 25
*compared to infants breastfed for the first three months of life.

40% more likely to have allergic dermatitis. 25
*compared to infants breastfed for the first three months of life.

52% more likely to have from coeliac disease. 18
*compared to infants who were breastfed when gluten containing foods were introduced to their diet.

30% more likely to have acute myeloid leukemia. 24
*compared with infants breastfed more than 6 months.

10% - 30% more likely to become obese later in life. 24
*compared to breastfed infants.

2 times more likely to die from SIDS. 21, 24, 28
* compared to breastfed infants

30% more at risk of mortality in the US. 24
*compared to infants ever having been breastfed.

Note: I haven't included the risks to the mother of not breastfeeding, which involve increased risk of different cancers and osteoporsis.

I hope these figures have been helpful, and please don't feel like I'm putting you down if you choose to or need to formula feed. We are all doing the best we can and know what's best for our own families.

Sources:

1.Relation between infant feeding and infections during the first six months of life.
http://www.ncbi.nlm.nih.gov/pubmed/7844664

2.Breastfeeding and Asthma in Young Children
Dell S, To T. . Arch Pediatr Adolesc Med 155: 1261-1265, 2001

3.Maternal asthma, infant feeding, and the risk for asthma in childhood.
Oddy WH, Peat JK, de Klerk NH. J. Allergy Clin Immunol. 110: 65-67, 2002

4.Breast-feeding in relation to asthma, lung function, and sensitization in young schoolchildren
http://www.jacionline.org/article/S0091-6749(10)00203-4/abstract#

5.Breast-Feeding Lowers the Frequency and Duration of Acute Respiratory Infection and Diarrhea in Infants under Six Months of Age
http://jn.nutrition.org/content/127/3/436.full.pdf+html

6.Breastfeeding and the risk of hospitalization for respiratory disease in infancy.
Bachrach VRG, Schwarz E, Bachrach LR. Arch Pediatr Adolesc Med. 157: 237-243, 2003

7.Prospective study of breast-feeding in relation to wheeze, atopy, and bronchial hyperresponsiveness in the Avon Longitudinal Study of Parents and Children (ALSPAC)
http://www.jacionline.org/article/S0091-6749(08)00618-0/abstract

8. Episodes of illness in breast-fed and bottle-fed infants in Jerusalem.
http://www.ncbi.nlm.nih.gov/pubmed/6469558

9.Prolonged and Exclusive Breastfeeding Reduces the Risk of Infectious Diseases in Infancy
http://pediatrics.aappublications.org/content/126/1/e18.full.html

10.Protective effect of breast feeding against infection – full text
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1661904/pdf/bmj00160-0017.pdf

11.Protective effect of exclusive breastfeeding against infections during infancy: a prospective study
http://www2.cfpc.ca/local/user/files/%7B5BB531F4-3A35-4BDD-819D-011D3614CA69%7D/Arch%20Dis%20Child-2010-Ladomenou-adc.2009.169912.pdf – full text

12.Risk factors for severe acute lower respiratory tract infection in under-five children.
Broor S, Pandey RM, Ghosh M, Maitreyi RS, Lodha R, Singhal T, Kabra SK. Indian Pediatr 38: 1361-1369, 2001

13.Breast milk and neonatal necrotising enterocolitis.
http://www.ncbi.nlm.nih.gov/pubmed/1979363
*compared to exclusively breast-fed preterm infants.
Formula fed preterm infants born at more than 30 weeks gestation who were exclusively formula fed were 20 times more likely to have necrotizing enterocolitis, compared to infants born at more than 30 weeks gestation who were exclusively breast fed. 13
With the fall in the use of breast milk in British neonatal units, exclusive formula feeding could account for an estimated 500 extra cases of necrotising enterocolitis each year. About 100 of these infants would die. 13

14.Donor human milk versus formula for preventing necrotising enterocolitis in preterm infants: systematic review
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1756003/pdf/v088p00F11.pdf

15.Neonatal necrotising enterocolitis
http://bpsu.inopsu.com/publications/reports/nnec.html

16.Breastfeeding and the Risk of Hospitalization for Respiratory Disease in Infancy – GOOD!
http://archpedi.ama-assn.org/cgi/reprint/157/3/237.pdf – full text

Because respiratory disease is the leading cause of hospitalization in young children—and each such hospitalization in infancy costs on average $3500, with more than 250000 such admissions in 1996—clearly there are large financial implications to this report.
From this study, we estimate that for every 26 women who exclusively breastfeed for 4 months, one LRTD hospitalization might be avoided. Likewise, since early severe respiratory illness is a recognized risk factor for asthma, 67,68 breastfeeding may be important to the prevention of asthma, with its significant health costs. 9,46,69,70

17.A Longitudinal Analysis of Infant Morbidity and the Extent of Breastfeeding in the United States
https://www.ncbi.nlm.nih.gov/pubmed/9164801

18.Effects of breast feeding on risk of coeliac disease: a systematic review and meta-analysis of observational studies. Akobeng A K et al. Arch Dis Child 91: 39-43, 2006
Continued breastfeeding limits the actual amounts of gluten received. Breastfeeding protects against intestinal infections - infections can increase the permeability of the infant's gut and therefore allow the passage of gluten into the lamina propria. Breastmilk IgA may reduce the immune response to ingested gluten, or immune modulation may occur through specific T-cell suppressive effects.
*compared to infants who were breastfed when gluten containing foods were introduced to their diet.

19.Infant feeding and Hospitalization during the first six months of life – full text
http://jpma.org.pk/PdfDownload/1261.pdf

19.Differences in morbidity between breast-fed and formula-fed infants.
http://www.ncbi.nlm.nih.gov/pubmed/7751991

20.Breastfeeding and the risk of sudden infant death syndrome.
http://www.ncbi.nlm.nih.gov/pubmed/8282468

21.The role of breastfeeding in sudden infant death syndrome. – meta-analysis, good!
https://www.ncbi.nlm.nih.gov/pubmed/11138219

22.Absence of breast-feeding is associated with the risk of type 1 diabetes: a case-control study in a population with rapidly increasing incidence.
Malcove H et al. Eur J Pediatr 165: 114-119, 2005

23.Breastfeeding as prophylaxis against atopic disease: prospective follow-up study until 17 years old. Saarinen UM, Kajosarri M. Lancet 346: 1065-1069, 1995
http://www.ncbi.nlm.nih.gov/pubmed/7564787

24.The Risks of Not Breastfeeding for Mothers and Infants – good!
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2812877/

25. Risk factors for atopic dermatitis in infants at high risk of allergy: The PIAMA study.
Kerkhof M, Koopman LP, van Strien RT, et al. Clin Exp Allergy 33: 1336-1341, 2003
http://www.ncbi.nlm.nih.gov/pubmed/14519137

26.Risk Factors for Invasive Pneumococcal Disease in Children: A Population-based Case–Control Study in North America
http://pediatrics.aappublications.org/content/103/3/e28.full

27.How protective is breast feeding against diarrhoeal disease in infants in 1990s England? A case‐control study
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2065954/

28.Breastfeeding and Maternal and Infant Health Outcomes in Developed Countries.
http://www.ncbi.nlm.nih.gov/books/NBK38333/#B106859