Packed Lunch: Breastfeeding

31 October 2011
 A mother breastfeeding her child. Wellcome Images

A mother breastfeeding her child. Wellcome Images

I had a bone to pick as I walked into the Forum for this Packed Lunch on breastfeeding. In January, while on maternity leave, I remember quite clearly reading an article about how it could be harmful to breastfeed babies for too long. There I was in my pajamas, breastfeeding my six-month-old, reading this on my iPhone. Incidentally, I had started introducing fresh fruit and vegetables – actually on Christmas Day – but that was more out of my baby snatching a carrot and a parsnip off my plate than anything else.

The article’s ideas questioned government advice and WHO recommendations, both of which I took quite seriously. At the time, I had enough to worry about without these unknown scientists undermining something I felt proud to have accomplished – giving my baby the best start to life. It wasn’t helped by reading the study had industry funding – I imagined greedy formula and baby food manufacturers rubbing their hands with the publication of this article.

Now, as I sit down, I look around to see if there are any other fuming mothers, ready for a fight. I spot only one mother – breastfeeding happily, I note – and two (visibly) pregnant women. The researcher, Mary Fewtrell from the Institute of Child Health at UCL, sat – somewhat nervously, I thought – waiting to be grilled, no doubt.

And interestingly enough, not five minutes in, she mentions that she wasn’t entirely happy with the billing for this talk – and the representation in the media. She fully supports breastfeeding, she says, and is a member of the NCT and has been a breastfeeding counselor. And as for industry funding, she says apparently that’s quite a normal thing to have – they have no say in experimental design or publication. I still don’t know how I feel about that, to be honest. I’d rather the money come from elsewhere.

So then, what was her motivation for the article, published in the BMJ? If you only read the news, you’d think she was out to undermine all breastfeeding mothers. But Fewtrell says actually, she’s trying to address the lack of data supporting these recommendations. She points out that WHO’s stance, taken in 2001, was based on a systematic review by scientists, who actually also called for more randomized trials. She says she’d rather get more people to even try breastfeeding – because of the very strong evidence over the reduction of risk of infection, in addition to other lesser-supported benefits in brain development, for example – than try and make mothers feel guilty for not meeting a goalpost of 6 months. This makes sense to me.

Fewtrell also made an interesting point in that she says she feels pressure to say the ‘right’ thing when she publishes, to interpret the data in a way that supports something ‘good’. That’s not the way science should work, she says – the data needs to speak for itself, and she can’t bias it. All she can do is try to add to a body of evidence.  This makes sense too.

She’s now undertaking a randomized trial, based in Iceland (where breastfeeding rates are higher). The trial involved women who were still breastfeeding at 4 months, who were then asked to either continue breastfeeding exclusively until 6 months or begin introducing solids alongside breastmilk.

By the end, I felt somewhat mollified. I still have concerns about the way that science can be twisted in the media. In the case of breastfeeding (which isn’t easy at the best of times!), it can be extremely undermining to hear conflicting advice all the time. My baby’s now 14 months, and I feel confident I did the right thing by her – at least on that point. Now I can move on to worrying about her university tuition fees…