Breastfeeding Claims Under Attack...Again

In an article published on abc.com on April 27, Lauren Cox asserts that claims about the benefits of breastfeeding are overblown. This comes about a month after that Atlantic article in which Hannah Rosen disputed the medical benefits of breastfeeding. I actually responded to the Atlantic article in a previous post.

This interesting timing of these 2 articles undermining the benefits of breastfeeding in such a short period of time makes me wonder what's up. I've thought of several possible reasons
1. Some mothers may feel pressured by the growing pro-lactation movement and are reacting to that perceived pressure in writing.
2. Maybe the artificial human milk industry has done a pretty decent job of convincing the general public that breastmilk and infant formula are about equal.
3. Or perhaps, as I wrote in my previous post, the studies that do indeed show conclusive benefits are titled and the abstracts are written in such a way that artificial milk isn't depicted as a causative factor in multiple negative infant outcomes.

Whatever the reason, it is more important than ever that breastfeeding advocates rely on solid scientific evidence for every claim we make. The American Academy of Pediatrics Policy Statement, Breastfeeding and the Use of Human Milk, contains 216 references to studies, scholarly articles, and public policy documentation dealing with the superiority of breastmilk over artificial milk for infants. While it may not be feasible to read every study in detail, a cursory review of this literature demonstrates overwhelming, objective evidence gathered in reproducible study conditions that repeatedly prove the inferiority of milk substitutes.

It is true that some mothers are unable to breastfeed for one reason or another. And some mothers do struggle with supply issues. A lact-aid with supplement can help. Nevertheless, there is an International Code of Marketing of Breastmilk Substitutes which strictly prohibits many of the kinds of marketing which the large infant formula companies do in this country. Until the United States government decides to enforce this code, we will continue to see the systematic undermining of breastfeeding in this country. No doubt about it, our work is cut out for us! But we have science and nature on our side, and that's a winning combination!

DHA in Infant Formula

A report released last year by the Cornucopia Institute, a Wisconsin based group devoted to fighting for the family-based farm, raises some very serious questions about the safety of the DHA and ARA that are added to many infant formulas. Much of the concern comes from the way in which these additives are produced in the laboratory setting.

What Is DHA and Why Is it Important?

DHA stands for docosahexaenoic acid. It is a long chain Omega 3 fatty acid which occurs naturally in breastmilk, in many cold water fish, in eggs, and in some algae and fungi. It can be synthesized in the liver, from another Omega 3 fatty acid that is found in foods like walnuts and canola oil. It is also found in the grey matter of the brain. Many researchers believe that the presence of DHA in the infant diet optimizes brain development.

What is ARA and Why Is it Important?

ARA stands for arachidonic acid. It is a long chain Omega 6 fatty acid which also occurs naturally in breastmilk as well as in some meats and in eggs. Like DHA, it is also found in the brain, and is considered to be a key component for optimal brain development. If DHA is added to infant formula without ARA, the aomount of ARA inthe infant's tissues actually decreases. For that reason, these two fatty acids are always added together.

How Are These Acids Created in the Lab?

Martek Biosciences Corporation has patented a process to create both DHA and ARA in the laboratory setting. The problem is that the laboratory products are not the same as the naturally occurring products in human milk. In fact, the DHA that is added to formula is actually DHASCO (docosahexaenoic acid single cell oil), and the ARA is actually ARASCO (arachidonic acid single cell oil). They are strudctually different from the DHA and ARA that a breastfeeding infant receives.

DHASCO is created from algae grown in tightly controlled fermentation conditions in a solution of glucose and yeast. Then the oil is extracted using hexame, a toxic petroleum by-product that has been associated with disorders of the central nervous system. The hexane is then removed. What remains is only about 40-50% DHA in a dilution of sunflower oil.

ARASCO is extracted from soil fungus using a similar process. According the Martek documents hexane is used in the processing of ARASCO as well.

Do These Additives Improve Formula?

The makers of infant formulas like Lipil and Good Start are quick to say they do. In fact, they claim that formula is now more like breastmilk than ever before. Nevertheless, ongoing research fails to show a significant beneficial effect. In early documents marketing their DHASCO and ARASCO to the formula companies, they claimed that even if these additives didn't make a difference, they could be "widely incorporated into infant formulas, as a marketing tool...." (Quoted in International Baby Food Action Network (2004) Breaking the rules, stretching the rules 2004: evidence of violations of the international code of marketing of breastmilk substitutes and subsequent resolutions.” , edited by Yeong Joo Kean and Annelies Allain. Available online at http://www.ibfan.org/english/pdfs/btr04.pdf. Last accessed on July 17, 2007. Source of the quote: Martek Biosciences Corporation, Investment Thesis 1996.)

Do They Cause Any Harm?

According the the Cornucopia report, the FDA has received 98 reports of adverse effects in infants that have been attributed to the use of DHASCO and ARASCO fortified formulas. One of the most common complaints is intestinal problems characterized by diarrhea. Some babies have even suffered dehydration and been admitted to Neonatal Intensive Care Units as a result of their inability to tolerate this formula.

What Should the Consumer Do?

Ideally, every mother would breastfeed her baby. However, some mothers face real struggles with nursing or find themselves in a situation where they must use formula. It is wonderful to live in a country where safe infant formula is readliy available. Nevertheless, mothers must recognize that no formula will ever replicate all the qualities of breastmilk. A mother should talk with her pediatrician about any concerns she has. If she is using a DHASCO/ARASCO enhanced formula and notices any gastro-intestinal symptoms, she should immediately contact her doctor and change to a formula without these addititives.

Mothers must always remember that they are the first and most important advocate their children will ever have. When it comes to feeding time, a mother must be sure she is truly giving her baby the best possible nutrition. Perhaps the Cornucopia report will help mothers do just that!