>>>Necrotizing enterocolitis is almost exclusively found in FF babies.<<<<
If that is true, then why does this study: http://www.ahrq.gov/clinic/tp/brfouttp.htm conclude "Our meta-analysis of four randomized controlled trials of breast milk versus formula in comparing the outcome of NEC demonstrated that there was a marginally statistically significant association between a history of breast milk feeding and a reduction in the risk of NEC (P = 0.04). The estimate of the reduction in relative risk ranged from 4 percent to 82 percent. The absolute risk difference between the two groups was 5 percent."
The relative risk range is huge. The absolute risk range is small, though notable and certainly a good reason to offer bmilk if your baby is premature.
Both these articles and the NEC information above suggest it's very important to offer bmilk to early preemies in the first weeks of life in the NICU. Though of the two, the E sakazakii infection seems to be the only one that would occur exclusively in FF'd babies.
>>>>There are many women who drink, but whose babies don't fall into these categories. These babies may have subtle issues which cannot definitively be attributed to alcohol, but are strongly suspected to be due to the alcohol.<<<<
Sure, but then how can we know that their problems are attributed to alcohol? Or would it be strongly suspected because of the high correlation between regular alcohol use during pg and physical, mental and behavioral problems in children? Doesn't the high correlation make the what-if easier? So we say this child has problems, we know drinking causes problems, we might rightly suspect the problems were related to mom drinking throughout her pg.
Then turn that analogy around to formula use, other than contaminated formula or a direct allergy to what is in the formula.... if a baby presented with an ear infection, pneumonia, diarrhea, eczema, asthma, childhood obesity, diabetes, leukemia, or a child died from SIDS or NEC would there be a reason to strongly suspect the child would not have had those illnesses or not have died if only they had been bf'd? On what basis could that conclusion be made (if one were to assert such a thing). We know that bf'd babies do experience all those illnesses, don't we? So the what-if game is harder, because you could be bf'd and still have those things happen based on genetics, exposure to contagious disease and/or family behavioral patterns.
>>>That's the similarity. If she didn't drink, but her child had issues, at least she *knows* that it wasn't drinking which led to the issues. If she doesn't FF, but her child has issues, at least she *knows* that it isn't FF which led to the issues.<<<<
I agree with that thought process, but I think it also matters what the "issues" are. Does the child have brain abnormalities that look like those of children with alcohol related traumas, were they low birth weight even though full term? Small head size? Does the child have some of the facial features known to be associated with drinking throughout pg? A large number of factors and features associated with the fetal alcohol syndromes or just one or two of them? What issues are we talking about?
>>>Nope, no link ... I had some before when we were on the topic (few months ago? longer?), but I don't have time to find them again ... I just came back to the board one more time before going to pick up DD ... if I get a chance later I'll see if I can find it.<<<<
I will be interested to read them if you can find them. I have found nothing that suggests NEC is almost exclusively in ff'd babies. I do recall when mine were first tube fed I was talking to the Neonatologist and he said now we watch for infection. He seemed concerned about infection for my babies and they were receiving bmilk, I assume that includes the risk of NEC given that preemies have much higher risk of NEC.
If you look at the link I provided to the AHRQ study you would see that your study was included there, compared with other similar studies as well as four randomized controlled trials. Your study (and others) apparently included infants who were fed fortified maternal milk (which I think is like supplementing) compared to those exclusively ff'd, so even having some bmilk was helpful in babies not getting NEC (if I am reading them correctly). In the AHRQ study the absolute risk difference was 5% between the ff'd and bf'd groups when looking at all the studies available. Though 5% is significant given the high mortality rate of NEC, it's hardly the case that NEC occurs almost exclusively in ff'd infants.
The metaanalysis isn't that bad. There is a brief but clear summary on each risk somewhere around page 17 of the pdf, about one paragraph for each disease/illness. If you search on NEC you can skip easily to the detail section which is only about a page and 1/2. Or you can take my word for it, that works too.
>>I don't know about IQ points and cocaine use, but some studies have shown no difference in IQ and some have shown as low as 1.6 difference in IQ points for non-bf'd vs. bf'd. So I would not think they are similar. How many IQ points are lost from cocaine use?<<
The loss in IQ points for not breastfeeding and the loss in IQ points for using cocaine during pregnancy are both in the 3-7 point range.
>>And how does that compare to the direct risk of alcohol leading to alcohol related birth defects?<<
Not even close.
But the original question didn't seem to be about the magnitude of the impact, it was about the correlation, right? In that sense there is no difference, more bf=better outcome, more alcohol=worse outcome.
This article proposes the components in breastmilk that reduce the risk of NEC.
“Anti-inflammatory agents, such as platelet activating factor (PAF)-acetylhydrolase and interleukin 10, may reduce the risk of NEC. PAF-acetylhydrolase degrades PAF, a potent mediator of intestinal injury induced during necrotizing enterocolitis . Interleukin-10 is an antiinflammatory cytokine that decreases inflammation and injury to the gastrointestinal tract . In addition, polyunsaturated fatty acids modulate inflammatory reactions and may protect the gastrointestinal tract from NEC.”
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>>>Necrotizing enterocolitis is almost exclusively found in FF babies.<<<<
If that is true, then why does this study: http://www.ahrq.gov/clinic/tp/brfouttp.htm conclude "Our meta-analysis of four randomized controlled trials of breast milk versus formula in comparing the outcome of NEC demonstrated that there was a marginally statistically significant association between a history of breast milk feeding and a reduction in the risk of NEC (P = 0.04). The estimate of the reduction in relative risk ranged from 4 percent to 82 percent. The absolute risk difference between the two groups was 5 percent."
The relative risk range is huge. The absolute risk range is small, though notable and certainly a good reason to offer bmilk if your baby is premature.
Both of the links below give several theories on what causes NEC, neither make the claim you have above that it's found almost exclusively in ff'd babies. Do you have a link that supports your statement above so I may read it myself?
http://emedicine.medscape.com/article/977956-overview
http://kidshealth.org/parent/medical/digestive/nec.html
<<
I would agree that if the formula is contaminated that would be a risk of formula that would not pertain to bf'd infants. I found these articles on Enterobacter sakazakii infections:
http://www.medscape.com/viewarticle/431689
http://www.foodborneillness.com/enterobacter_sakazakii_food_poisoning/
Both these articles and the NEC information above suggest it's very important to offer bmilk to early preemies in the first weeks of life in the NICU. Though of the two, the E sakazakii infection seems to be the only one that would occur exclusively in FF'd babies.
>>>>There are many women who drink, but whose babies don't fall into these categories. These babies may have subtle issues which cannot definitively be attributed to alcohol, but are strongly suspected to be due to the alcohol.<<<<
Sure, but then how can we know that their problems are attributed to alcohol? Or would it be strongly suspected because of the high correlation between regular alcohol use during pg and physical, mental and behavioral problems in children? Doesn't the high correlation make the what-if easier? So we say this child has problems, we know drinking causes problems, we might rightly suspect the problems were related to mom drinking throughout her pg.
Then turn that analogy around to formula use, other than contaminated formula or a direct allergy to what is in the formula.... if a baby presented with an ear infection, pneumonia, diarrhea, eczema, asthma, childhood obesity, diabetes, leukemia, or a child died from SIDS or NEC would there be a reason to strongly suspect the child would not have had those illnesses or not have died if only they had been bf'd? On what basis could that conclusion be made (if one were to assert such a thing). We know that bf'd babies do experience all those illnesses, don't we? So the what-if game is harder, because you could be bf'd and still have those things happen based on genetics, exposure to contagious disease and/or family behavioral patterns.
Malcolm Gladwell Blink
Nope, no link ... I had some before when we were on the topic (few months ago?
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I found the old post after all (6 months ago).
http://messageboards.ivillage.com/iv-psbfvbottle/?msg=4988.436
Here's the abstract to the
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>>>That's the similarity. If she didn't drink, but her child had issues, at least she *knows* that it wasn't drinking which led to the issues. If she doesn't FF, but her child has issues, at least she *knows* that it isn't FF which led to the issues.<<<<
I agree with that thought process, but I think it also matters what the "issues" are. Does the child have brain abnormalities that look like those of children with alcohol related traumas, were they low birth weight even though full term? Small head size? Does the child have some of the facial features known to be associated with drinking throughout pg? A large number of factors and features associated with the fetal alcohol syndromes or just one or two of them? What issues are we talking about?
>>>Nope, no link ... I had some before when we were on the topic (few months ago? longer?), but I don't have time to find them again ... I just came back to the board one more time before going to pick up DD ... if I get a chance later I'll see if I can find it.<<<<
I will be interested to read them if you can find them. I have found nothing that suggests NEC is almost exclusively in ff'd babies. I do recall when mine were first tube fed I was talking to the Neonatologist and he said now we watch for infection. He seemed concerned about infection for my babies and they were receiving bmilk, I assume that includes the risk of NEC given that preemies have much higher risk of NEC.
Malcolm Gladwell Blink
Malcolm Gladwell Blink
What I was remembering was the "twenty times" rate from that article, and I extrapolated.
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Malcolm Gladwell Blink
>>I don't know about IQ points and cocaine use, but some studies have shown no difference in IQ and some have shown as low as 1.6 difference in IQ points for non-bf'd vs. bf'd. So I would not think they are similar. How many IQ points are lost from cocaine use?<<
The loss in IQ points for not breastfeeding and the loss in IQ points for using cocaine during pregnancy are both in the 3-7 point range.
>>And how does that compare to the direct risk of alcohol leading to alcohol related birth defects?<<
Not even close.
But the original question didn't seem to be about the magnitude of the impact, it was about the correlation, right? In that sense there is no difference, more bf=better outcome, more alcohol=worse outcome.
>>are there any diseases that occur in ff'd babies that do NOT occur in bf'd babies<<
Necrotizing enteritis - or something like that.
This article proposes the components in breastmilk that reduce the risk of NEC.
“Anti-inflammatory agents, such as platelet activating factor (PAF)-acetylhydrolase and interleukin 10, may reduce the risk of NEC. PAF-acetylhydrolase degrades PAF, a potent mediator of intestinal injury induced during necrotizing enterocolitis . Interleukin-10 is an antiinflammatory cytokine that decreases inflammation and injury to the gastrointestinal tract . In addition, polyunsaturated fatty acids modulate inflammatory reactions and may protect the gastrointestinal tract from NEC.”
http://www.uptodate.com/patients/content/topic.do?topicKey=~9TKjOHdMbWyMPyQ
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