Tuesday, 21 September 2010

An infant feeding research dilemma

Just after Snowflake's birth, we were asked if we'd be willing to take part in a piece of research on infant feeding. The research was explained to me and once both parents had consented, we embarked on a route of rather a lot of data gathering. Part of this is noting down every feed in the first 9 days, regular measurements and a poo and feeding record at certain intervals (my initial enthusiasm is a bit dampened because the whole thing is a pain in the bum, especially with a cluster feeding baby and a mummy who doesn't wear a watch).

Initially, my understanding of the research was that it attempted to increase knowledge of how breastmilk and formula affect the development of obesity and heart disease in the population. There seems to be some understanding that if an infant is breastfed exclusively for even just the first 10 days, this leads to a significant reduction of cases of obesity and heart disease compared to formula fed babies. What is not established is why exactly this is so. The research tries to compare three groups of babies - those breastfed exclusively for the first 10 days, those fed exclusively on a normal formula and those fed on a newly developed formula which mirrors breastmilk in that it contains less calories from fat (less than normal formula). So the idea is that the calories from fat content in formula milk in the early days may set up the body in a way that it will require more fat and carbohydrates in the future.

Breastfed babies who take part in this study (i.e. Snowflake) provide the base line against which negative effects in relation to obesity/heart disease of either formula are measured.

The background to the effort is that because so many mothers decide not to breastfeed, if a formula could be designed which was closer to breastmilk in that it had the same beneficial effect on preventing obesity and heart disease, this would significantly improve the nation's health.

So here is my dilemma: I'm taking part in a study which, in effect, may lead to the promotion of formula feeding. While I accept that some mothers can't breastfeed and some choose for very good reasons not to breast feed (and I'm supportive of this choice), I'm also dismayed at the low breastfeeding rates particularly in the so called "deprived" areas of Glasgow (and the country), the link between poverty and low rates of breast feeding cannot be denied and it contributes to creating health inequalities from the point a baby is born, arguably earlier. I've talked about the significance of promoting breastfeeding from a poverty and health equalities perspective before.

I accept that it is easier to change formula than it is to change culture. I'm not sure if it's the right way or if it will most likely lead to even more mothers not breastfeeding. My worry is also that the knowledge obtained through this study, which is supported by the NHS, funded by pharmaceutical companies, may eventually be used by formula manufacturers who don't have the same ethics that the current funders and researchers have. It's all good and well to assure me that breast milk will always be best for baby, but a formula that can be marketed as preventing obesity and heart disease just like breast milk must be extremely attractive for less ethically committed manufacturers.

For now I've done my research and all the background of the study is kosher, but once the knowledge is out, can there be control over how it's used? And another question, who am I to decide that the only way to improve the nation's health is to go the long way and change culture, would it not actually be better to change what we can as soon as we can? If this new, fat reduced formula is better for the infant's health than the formula currently available, and if particularly mothers living in deprived communities aren't going to breastfeed anyway, is the ethical thing to do not to support the development of an improved formula that will help reduce health inequalities?

I have no final answer to my questions, but would be interested to hear what you think about all of this.



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