Tuesday, February 08, 2011

Formula, Food, and Fat: Put Down That Enfamil, Lady!

Girl, 3, attributes slimness to eating well (i.e. breastmilk)
Formula-fed babies get fat if they eat food before 4 months according to the latest entry in the breastfeeding-is-god literature, a study just published in Pediatrics no less.

The babies lucky enough to get the real deal, the liquid gold, the boob? 

The Chosen Few (i.e. breastfed for at least 4 months) could nosh on cereal and other delectably mushy meals before the recommended 6 months without becoming obese at age 3.  But their formula-fed friends (i.e. not breastfed for 4 months or formula-fed from birth*) paid the price for the "early introduction" of solid foods.  Almost 6 times as likely to be pudgy preschoolers. 

That formula goes straight from the lips to the hips, don't ya know?

These "early food" findings come to us by way of Project Viva, a name better suited to paper products and pharmaceuticals than infant health:
Project Viva is a ground breaking longitudinal research study of women and children. The goal of Project Viva is to find ways to improve the health of mothers and their children by looking at the effects of mother's diet and other factors during pregnancy on her health and the health of her child. The information we collect enables us to investigate, for example, the effects of diet on child development and obesity, how diet and the environment influence the development of asthma in children, and how a woman's pregnancy is affected (by - certainly not "has affected") lifetime experiences of racism or violence.  From the Project Viva website.  
Borrrriiiinnngggg.  Nobody ever corrected the typo above because nobody but me (and maybe you) has ever read it.  Before you swallow this one....

I bet the researchers probably didn't bother with what mommy fed the little darling after the boob or the bottle.  At least the media reports didn't mention it nor the Viva website and because I didn't want to spend the money reading the actual article I can only guess.  Betcha two Tootsie Rolls they didn't ask how often their toddlers dined at McDonald's or drank, eek, soda. 

So it's perfectly reasonable to ask if the parents who didn't follow the official breastfeeding procedures (i.e. give birth, pull out breast, attach mouth, repeat, repeat, repeat) also gave the finger to the organic-complex carbohydrates-5-fruits-and-veggies- food guidelines.    

Hhhhmmm.  What do you think?

I don't know how you do a longitudinal study on diet and obesity without asking about food.  It's as if  humans magically stop eating after infancy.  

But since I like solving mysteries please allow me to speculate.

Viva (Las Vegas!!) started out "looking at the effects of mother's diet and other factors during pregnancy on her health and the health of her child."  So the researchers didn't think about those questions because they were so focused on the womb and the breasts (as in breast milk). 

Can you imagine if they had asked about what the kids actually ate?

How would you describe the foods your child consumes in a typical meal:
a. Very Healthy
b. Healthy
c. Unhealthy
d. No comment


I serve my child a green vegetable:
a. Every day
b. Once a week
c. Once a month
d. Once a decade


The snacks I usually serve my child are:
a. Apples and carrots
b. Yogurt and pretzels
c. From the vending machine
d. Okay, got me, I'm a bad, bad parent

Did I mention the research team hailed from Harvard.  Why of course!! The very belly (or butt)  of breastfeeding research as witnessed by recent studies.  (See last post)

For a good take on the "breastfed babies don't get fat" phenomenon go read Rebecca Goldin over at STATS. Can breastfeeding halt obesity - or is the media misreading the research?

The last two breastfeeding studies I've felt the urge to debunk came straight from Cambridge from two different groups of Harvard researchers.  How is it our best and brightest have been so blinded by the breast?
 
Peeps, if this is the best our best has to offer then I'm going to brush up on Mandarin.  Assuming our Chinese friends haven't declared a war on obesity, here's the first lesson:

要薯片吗(want fries with that?)

* Try telling the mommies who stuck it out for 3.75 months they didn't really qualify for The Breastfeeding Merit Badge. 

15 comments:

TherExtras said...

You are truly in your element this time, Polly. You are so needed on this issue, too. Wish I could think of a clever analogy to the wrongness of claims under the Viva moniker.

Too many are unable to connect the dots and are thus prey to messages concocted by people who should know better.

What to do? What to do?

Barbara

Polly Palumbo, Ph.D. said...

Thanks, Barbara, wish I could claim some of the credit on this one but the Viva team has made it so darn easy this time! Did you catch the earnest photos of the project reunion at like the local Fridays, the researchers cavorting with the research participants. Just when I thought I'd seen everything...

The Fearless Formula Feeder said...

Okay, am I missing something here, or does this study also state that the babies who were actually had the LEAST chance of being obese were the FORMULA FED kids who started solids after 4 months??

Or did I misread it?

Regardless, brilliant as always, Polly. And good catch on that typo. ;)

Polly Palumbo, Ph.D. said...

Did you get that in the paper? or a write-up? That would be interesting! I didn't read that but I didn't see the actual paper.

Anonymous said...

I really wish Michele Obama would read your post - her campaign to reduce childhood obesity is perpetutating the "belief" that BF will keep our kids from becoming obese! So frustrating.

Polly Palumbo, Ph.D. said...

Thanks, Anony! Maybe I'll email it to her. I forgot about her obesity efforts.

Nicole said...

Breastmilk is the best thing for your baby. Bottom line. I can NOT believe the amount of people that try arguing this. We are not talking about Tide vs Clorox......this is straight from nature, the way it is meant to be served. Formula is not the first (or second..) choice that is reccommended for babies. I see way too many babies coming into our office having to change formula over and over again because baby "can't handle it". It is called a substitute for a reason...if you can not BF for whatever reason (lack of GT, chemo, moms meds not safe for babe..) than it is acceptable. AND...the same goes for "noshing" before 6 months...it is not needed!

Polly Palumbo, Ph.D. said...

Hey Nicole, welcome and thanks for commenting. Are you a pediatrician? As I say repeatedly - I breastfed all 3 of my kids and believe there are some benefits though they turn out to be much smaller in the scientific literature than parents are led to believe based on its glorification in the pediatric community and media. I suggest any who is really interested in knowing about it to read Joan Wolf's book - Is Breast Best?. As for introducing cereal before 6 months - I posted about this last month - there is a growing belief that babies might benefit from cereal a couple months earlier for a variety of reasons. I just wish we could keep our minds open to the actual evidence on these complicated issues.

eggplant said...

I agree with Nicole. The snarky question, "Are you a pediatrician?" isn't lost on me either (if she was, why would that matter, since most only get a couple months-if that-of breastfeeding education anyway?). Gosh you know, I guess all those medical experts around the world really don't know anything. Thank you so much for clearing up the confusion! I feel like arguments like these are similar to arguing that drinking excessive amounts of alcohol in pregnancy might not REALLY be bad, since after all, it's all observational research, right? You claim to be a breastfeeding mother, but I doubt the veracity of this. How long were you feeding formula to your baby as well as breastfeeding? My son was formula fed for six months, was obese and constantly ill. I re-lactated eight months ago and (what a crazy coincidence!) he slimmed down, and hasn't been sick once! I guess my anecdote doesn't really mean much in the face of your oh-so-enlightening "research". All "articles" like this do is perpetuate the myth that formula is just as good when all research (even if it is observational) and COMMON SENSE tells us otherwise. Also- where are your credentials? Do you have a PhD is nutrition? Yeah, I didn't think so.

Also- Joan B. Wolf is an associate professor of gender studies at a Texas University. She has absolutely NO scientific training and attacks the issue of breastfeeding advocacy as being antithetical to feminism. Why don't you recommend readers to go to someone who is actually educated on the topic (instead of a jilted formula-feeding mom) on the subject? Oh riiiiight. I bet I can guess! ;)

Good luck spreading your misinformation, I sure the FFers who live off of this disgusting excuse for information will lap it up.

Polly Palumbo, Ph.D. said...

Hi Eggplant, thanks for reading. I always ask readers about their experience because I am curious. Also Nicole commented about seeing mothers in her office. No snark intended. I have never dissed someone who has commented on this blog. I don't appreciate personal attacks here.

Laura said...

Hi, I have never heard of you, nor read your work, so I don't know if this piece is representative of your overall demeanor, but it doesn't come across as informational and supportive of a mother's right to have access to correct and unbiased information as it does just plain catty. There are many reasons why breastfeeding's link to obesity is being explored by many researchers- and supported by Mrs. Obama. I think this study makes clear that for those who must use formula as an alternate food source for their infants, delaying solids is likely to help establish a pattern that can possibly be more protective against obesity- at least in early childhood. Yes, the food choices they make after that will count. But the point of THIS study was to say that breastmilk and formula are types of food as well- and as you noted, one cannot discuss diet and obesity without talking about food. The reality is that, as mammals, the correct food for our infants is species-specific milk. Knowing that formula- a poor attempt to mimic human milk- is widely used in our society (during the developmental stage when nutritional and habitual foundations are being established), it only makes logical sense that any decent observer would note the potential for causation. Human milk is produced by human mothers according to the unique needs of human children- including rapid brain development and a gradual increase in size, spanning an average of 18 years. Formula, in most cases, is derived from cow’s milk. Cows produce milk specific to the optimal growth of a calf- which includes the rapid development of bulk and size, and the minimization of brain development. This study, however, only mentions one aspect of obesity- and aims to relate it to the early introduction of solids. The simple fact is that the early introduction of solids is more detrimental to a formula-fed baby than it is to a breastfed infant.

Laura said...

Breastmilk contains compounds that help to seal off the gut, so that larger proteins cannot enter the bloodstream directly. Breastmilk also helps to establish healthy gut flora appropriate for proper human digestion and absorption. A breastfed baby’s system can tolerate the introduction of many foreign substances that a formula-fed baby may struggle with, be it allergen or alternate food source, because it has been primed by the very substance designed to promote proper development of the human digestive system: Human milk. Formula-fed infants have higher plasma-insulin concentrations, which can result in increased insulin resistance and affect the programming of insulin metabolism. Formula-fed infants also have higher levels of insulin-like growth factor I. Breastfed babies begin life on trace amounts of colostrum, establish a frequent feeding pattern that slowly takes their stomachs from the size of a large marble to the size of an egg. Formula fed babies are often begun in ½ oz. intervals, being offered 2 oz. of formula per feeding; increasing to 4 oz. long before a breastfed baby’s stomach can comfortably accommodate so much. If I told you to begin drinking a protein-rich nutrition shake after every meal, would you be surprised when your stomach grew to accommodate- and expect- more? (Would it be fair of me to suppose that your resulting obesity came from Mc Donalds?) There are many reasons why it is important to continue looking into infant feeding as a source of our nation’s obesity epidemic. It is also important to scrutinize the information made available to us, even if it begins to point away from arguments we have previously held. The more studies we see coming out, the more we see confounders being accounted for and the clearer picture we are able to uncover. Currently, the most reliable research we have establishes that, yes- breastfeeding initiation and ANY duration is important. Unfortunately, it also establishes that exclusivity matters- especially in the first 4-6 months- in regards to some issues, and that in others, results are dose-dependent. That is why current recommendations are that mothers breastfeed exclusively for 6 months and continue, with the addition of other foods (still not formula), for 2 or more years. This doesn’t make everyone happy- of course not! But the reality is that we all want what’s best for our children, and we do our best within our own limitations. You have established that your goal is to provide parents with a way to wade through “what the science really says and doesn't say - whether it contradicts famous pediatricians with best-selling books, behemoth parenting websites, celebrity moms/activists, or sloppy researchers with their mind-numbing mumbo jumbo.” So now, I wonder, as an advocate for giving parents balanced, complete information with which to make their own personal decisions, will you allow for science that contradicts you? Because this is just one study, there are many more- so… do you look to uncover the entire truth about a matter? Or do you simply seek to find individual studies you disagree with and delve no further?

Nicole said...

No, I'm not a pediatrician. I have taken and passed the CLC training. I am a breastfeeding peer counselor. I completely understand the heartache that some mothers experience due to a known or unexpected contradiction to breastfeeding, so the use of formula (if banked milk is not available) may be critical. To compare the two and claim that the difference is "minimal", shows a very ignorant side to the letters you are proudly displaying next to your name. I am not bashing FM feeders....I am extremely irked by the number of moms that think there is no difference. I have enough moms with two children...one BF one FM...(meaning-- same parenting skills, environment, income levels..) that can surely say the difference is there and it is far from the "smaller than we may be told" that you are claiming.

Anonymous said...

I think Polly’s question asking about people’s education/experience is a valid one. Being able to accurately read research is important. Wolf, herself states in her book that she too believed that BF had a multitude of benefits until she starting reading the studies for herself. The fact that Polly and Joan are PhDs gives them more credibility than most people that cite scientific research on the matter. Neither Polly nor Joan Wolf say that breast milk is better than formula. Both women say there are benefits to BF, but just not to the degree in which popular culture think. There is a need to understand what the science actually says and not just pick and choose. As Polly has discussed in previous posts and Wolf in her book; research that doesn’t show anything (like BF not having benefits) don’t get published b/c it didn’t “find” anything, getting published is the name of the game in research. The weakness of many of these studies has way more to do with than being observational studies. It’s confounding factors and not misrepresenting correlation for causation. I know this is an emotional and personal subject for many women, but we’re not discussing “beliefs” we’re talking about outcomes. The subject of this post is about BF and its outcome on obesity. The research does NOT suggest BF causes obesity, not even close.

Polly Palumbo, Ph.D. said...

Wow - I go away for a (WiFi-free) weekend and missed a lot of comments. Thanks to everyone for reading and commenting. I'd just like to remind everyone that this is not a space for personal attacks. Feel free to question me, my credentials (I've made them pretty clear in the past), but please let's try to focus on the research. There are plenty of places to voice opinions devoid of the actual studies. And let me state once again I breastfed all 3 kids and have the breasts to show for it though thank goodness this isn't the kind of blog where I'll show that evidence!

So, why do I focus on breastfeeding? I read a lot of studies in the course of a month and focus here on the ones that get more of the media attention. Why? Because so often the results get misterpreted or stretched and with the breastfeeding literature this is unfortunately too often the result.

Obviously many of you have a lot of knowledge about the subject and thanks for sharing, honestly, I appreciate a dicussion of facts. From my perspective, reading the literature, the research simply doesn't support the current recommendations nor the amount of vitriol apparent on blogs and message boards.

Laura, thanks for asking about research that contradicts my opinion.I almost always write on research (if the topic is breastfeeding) that shows benefits for it. Then I tell what the limitations/pluses are or the weaknesses/strengths. I cannot even think of a single study I've written about on the topic that showed no benefits (or were pro-formula). Why? Because hardly any get published and if they do, they aren't featured in the media often. (There are quite a few on allergy, asthma that I've followed over the last decade or more bc I have some severe ones and was worried about my born and unborn kids) But if they were, I would debunk those too. And because of the official recommendations and the current climate in this culture I feel it's necessary for somebody to question the evidence, especially when it's less than rigorous. Sometimes I side with the experts (i.e. vaccines-autism - which you can see on this blog I've followed for over a decade), sometimes not.

Of course there's room for personal preference and opinion but I think the actual evidence seems to get lost these days. As someone who's devoted decades of my life (including my prime child-bearing years) to designing, conducting and writing about research (across several disciplines), it pains me to see the science get left out or misinterpreted or worse, used to justify positions unsupported by the evidence.

I am not here to tell anyone how to feed, discipine, or otherwise parent their kids. That's your choice. But I will tell you what the studies say.

And I will say it in a snarky tone because otherwise I'd probably bore the hell out of you. I've bored myself to death writing things like "researchers have long been concerned by.....results showed a three-way interaction...the chi-square analyses demonstrated...blah blah blah." Who'd read that? It's like the journal articles all over again. Even the professionals don't read the actual journal articles - they just read the short abstracts according to recent surveys - bc they're boring and too detailed, no? I also firmly believe we need to make science more fun, that's another goal here at Momma Data. I'm not sure why more people don't try to make it more interesting.

Anyhow, thanks everybody.