eceptive advertising of artificial feeding products tends to obscure the real differences between breastfeeding and bottle feeding. Formula feeding and breastfeeding are not the same thing and marketing strategies of blurring the differences and creating perceptions of similarity have no substance. Health workers and governments bear a special responsibility to alert families to the hazards of artificial feeding and to protect maternal and infant health through International Code implementation.
Infant formula is associated with cognitive deficiencies in pre-term infants and school-aged children
Mother's choice to provide breastmilk and developmental outcome. Morley, et al. Arch Dis Child 63:1382-1385, 1988. Pre-term infants who were formula fed had lower Bayley Mental Development scores at 18 months than their breastfed peers, after adjusting for social, economic and demographic factors.
Breastmilk and subsequent intelligence quotient in children born pre-term. Morley, et al. Lancet 339: 261-264, 1992. Formula-fed pre-term infants had lower IQ scores at age 7 and 8 years than breastfed pre-term infants, after adjustment for mother's education, social and economic status.
Neurological differences between 9 year-old children fed breast-milk or formula-milk as babies. Lanting, et al. Lancet 344: 1319-1322, 1994. This retrospective study showed that at the age of 9 years, children who had been fully breastfed for the first 3 weeks of life had improved neurological development.
Formula-fed infants risk allergic symptoms at greater rates and in greater severity than breastfed infants
Infant feeding, wheezing, and allergy: a prospective study. Burr, et al. Arch Dis Child 68:724-728, 1993. Children with a family history of allergic disease who had ever been breastfed had a lower incidence of allergy or wheezing. The risk of wheezing was halved in breastfed children after allowing for employment status, passive smoking and overcrowding. Breastfeeding may confer long term protection against respiratory disease.
Anaphylaxis after ingestion of a recently introduced hydrolyzed whey protein formula. Ellis, et al. J of Ped 118: 74-77, 1991. Case study of infant with anaphylactic reaction after ingestion of hydrolyzed whey protein formula. Authors warn of possible allergic reaction despite manufacturers' claims.
Formula-fed infants show higher rates of infectious disease
Protective effect of breastfeeding against infection. Howie, et al. Br Med J 300: 11-16, 1990. After adjustment for confounding variables, babies who were breastfed for 13 weeks or more had significantly less gastro-intestinal illness than those that were bottle fed from birth.
Exclusive Breast-Feeding for at Least 4 Months Protects Against Otitis Media. Burris, et al. Pediatrics 91: 867-872. 1993. Infants exclusively breastfed for 4 months or more had 50% fewer episodes of acute otitis media. Exclusive breastfeeding for 6 months or more reduced the recurring otitis media rate to only 10%.
Secretory Anti-Giardia lambia Antibodies in Human Milk: Protective Effect Against Diarrhea. Walterspiel, et al. Pediatrics 93: 28-31, 1994. The amount of anti-Giardia lambia sIgA in human milk was associated with prevention of symptoms of diarrhea due to Giardia. This evidence further strengthens the importance of breastmilk in the prevention of diarrheal disease.
Relationship between infant feeding and infections during the first six months of life. Beaudry, et al. J Pediatrics 126; 191-197, 1995. The results of this retrospective cohort study show the protective effect of breastfeeding on respiratory disease for the first 6 months of life after adjusting for socio-economic factors, maternal age and cigarette consumption. Only one hospital admission occurred for respiratory disease during the breastfeeding weeks compared to 51 hospital admissions during the bottle feeding period.
Formula fed infants have more auto-immune disease
Infant feeding in Finnish children < 7 yr of age with diagnosed IDDM. Virtanin, et al. Diabetes Care 14: 415-417, 1991. Finnish children exclusively breastfed with delayed exposure to infant formula based on cow's milk had significantly reduced incidence of diabetes.
Infant feeding and childhood cancer. Davies, et al. Lancet 2: 365-368, 1988. The risk of developing childhood lymphomas was 5 to 8 times higher for artificially fed infants as compared to infants breastfed for six months or less.
Apotosis induced by a human milk protein. Hakansson, et al. Proc Natl Acad Sci. 92: 8064-8068, 1995. Selected apotosis (the destruction of unwanted cells), of tumour cells while leaving other cells intact on exposure to human milk factors (multimeric a-lactalbumin) suggests a role in the prevention of tumour growth and cancer prevention.
Formula fed infants have a higher mortality rate
Cancer from PCBs in breastmilk? a risk benefit analysis. Rogan, W. K. Ped Res 25; 105-, 1989. A risk benefit analysis in the US determined that for every 1000 infants born, four will die because they are not breastfed.
Cot death supplement Results from the first year of the New Zealand cot death study. Mitchel, E.A., et al. NZ Med J 104: 71-74, 1991. Identification of risk factors for sudden infant death syndrome in New Zealand concludes three factors - infants sleeping in prone position, parents smoking and not breastfeeding to account for 79% of death from SIDS.
Breast milk and neonatal necrotising enterocolitis. Lucas A. Lancet 336: 1519-1523, 1990. In the UK an estimated 500 extra cases of necrotising enterocolitis occur in pre-term infants exclusively formula fed. About 100 of these infants would die.
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