25 Jan

Book review: Successful Infant Feeding, by Heather Welford

This comprehensive book takes a broad view of infant feeding, including how-to sections for both breast and bottlefeeding, along with an interesting examination of the history and politics, and the social and emotional aspects of the subject. It gives enough detail to be useful to breastfeeding supporters and other health professionals, without being too dense for parents and parents-to-be.

I warmed to the book immediately on reading the opening chapter, about babies’ development over the first year. This sets the subject of feeding nicely into the wider context of babies’ needs; and yet, without pulling any punches about the risks of formula feeding, manages to be inclusive and non-judgmental about the range of choices that parents make. Importantly, Welford acknowledges that, for many parents, formula feeding is not a choice willingly or happily made, and that it is very hard for health professionals to get the right tone when it comes to supporting parents in making decisions about feeding.

This book is useful because as well as accurate how-to information, it also touches on a range of special situations and common concerns, briefly explains the WHO code, and looks at how individual babies’ feeding patterns might change over time. It even includes enough information on the introduction of solid food to render the purchase of anything by Annabel Karmel completely unnecessary.

The language used is crystal-clear and helpfully free of value-laden terms. I have already heard myself reciting bits of it in antenatal classes (while hoping that Heather won’t want any royalties!), have sent a copy to my sister-in-law who is expecting her first baby, and recommended it widely. It is the book that our profession has been waiting for, and should be on the reading list for anyone working with new parents.

15 Jan

Can breastmilk be made in a lab?

This is not intended as a ‘breast is best’ post, simply a list of the reasons why it would be impossible to make an exact replica of breastmilk in the lab. There are already many, many resources on this subject, and this is only intended as a simplified list.

  1. Breastmilk changes all the time according to the needs of the child. For example, in hot weather, it has a higher water content. As the child gets older and starts to toddle, the antibody count increases to counter the increased exposure to pathogens. If a baby is exposed to pathogens, an interaction between his saliva in the mother’s milk ducts causes appropriate antibodies to be made in the milk. Formula does not contain antibodies.
  2. Breastmilk also changes during each feed, becoming increasingly high in fat as the baby drinks. This is what causes baby’s internal appetite control to kick in. The fat content of formula does not change.
  3. Breastmilk contains antimicrobial and immune factors. Few of these can be made in a lab.
  4. Breastmilk contains the digestive enzyme lipase, which helps the immature gut to digest the milk. This is why it takes longer to digest formula milk, which is one of the reasons bottlefed babies go longer between feeds.
  5. The flavour of breastmilk changes according to the mother’s diet. Babies experience different tastes before starting solid food.
  6. Breastmilk contains human growth hormones. Formula milk, which is made from cow’s milk, contains bovine growth hormones.
  7. There are other ‘human’ factors which are impossible to make in a lab, including human iron. Breastmilk also contains lactoferrin, which helps the baby to digest the iron in breastmilk. As formula does not contain lactoferrin, the iron content has to be much higher in order for the baby to absorb sufficient quantities. High levels of iron can cause the gut to bleed, resulting in anaemia. Other micronutrients and vitamins are added to formula in high quantities, for the same reason.
  8. Some babies are allergic to cow’s milk protein. No babies are allergic to human milk protein.
  9. Breastmilk contains lactose, cholesterol and fatty acids that aid human brain development. Formula milk does not.
  10. Breastmilk is sterile. Formula powder is not. Ready-made formula is sterile but requires a lot more handling than breastmilk, which usually goes directly from breast to baby.
  11. No country has a government standard for formula. There is a minimum standard, but other than that, there are no rules for what can or can’t be added. Most ‘new’ ingredients are added for marketing, rather than health, reasons.
  12. Babies get more than just milk and its constituents, when they breastfeed. The benefits of lots of skin to skin are well-established.

UK formula companies spend £20 per baby on promoting formula. The government spends 14p per baby on promoting breastfeeding, and we know that ‘promoting’ breastfeeding is unhelpful. Would that £20.14 per baby was spent on supporting breastfeeding mothers, and then the question of whether or not formula could replicate breastmilk would be completely irrelevant.

The Ecologist: Breastmilk vs ‘formula’ food
Dr Sears on comparison of breastmilk and artificial milk
Kellymom on immune factors

10 Jan

Book review: You, Me and the Breast

This is a colourfully illustrated book about breastfeeding. Its simple story follows a mum and baby from birth to weaning, and mentions lots of memorable moments, such as snuggling up in bed with daddy, mama milk to comfort and soothe, and those relaxing moments where one’s ever-active infant becomes still for a little while at the breast.

Although it is clearly presented as a children’s book, I was a little confused about who the target audience was. Some of the information: ‘my nipple darkened… and gave off a rich smell’ sounds unnecessarily technical in a book for a small child. The cursive script was too difficult for my competent five year-old to read himself, and he had a lot of questions about the illustrations (‘which one is her hand?’ ‘why has she got birds in her hair?’).

It was nice to see dad included in some of the pictures, although I have reservations about the depiction of him ‘aeroplaning’ puréed food into the baby’s mouth.

On balance, the more books for children that normalise breastfeeding, the better. It would be good to see this widely available in local libraries and schools.


To order You, Me and The Breast with a 25% discount, just follow the link and use the discount code KH25 at the checkout.

04 Jan

Book Review: When Your Baby Cries, by Deborah Jackson

You are the still waters – p.57

You get the sense that, when giving the book its subtitle ’10 Rules for soothing fretful babies (and their parents)’ Deborah Jackson’s tongue was firmly in her cheek, as the basic tenet of the book is that there are very few rules, only a handful of general guidelines that each parent will apply in their own way.

The first, and probably most important of these, is to relax. Despite having been given a copy of When Your Baby Cries by a wise friend, towards the end of pregnancy, it took me a long time to master the art of calm. I’m constantly surprised when my feedback as a BFC describes me as calm, and I wish I could harness this within my own family! Motherhood maximises our potential for guilt, anxiety, self-doubt, and sleep-deprived irritability; inner calm can be hard to find.

The ‘rules’ in the book are based around learning about babies, and specifically, learning about your own baby, so that each parent finds their own way to respond. There is an emphasis on understanding and meeting the baby’s needs through love and attention, as opposed to trying to make the baby conform to modern notions of good behaviour. Scattered throughout the text, quotations, statistics and facts about baby care in other cultures illustrate the author’s gentle suggestions and explanations.

As the mother of a colicky baby, I found rule 4 particularly helpful, as this gave me permission not to have to stop him from crying, but simply to be there for him and hold him, and accept that I could not understand why he cried. It was a good lesson that we were both on the same side.

I have some concerns with the suggestions of homeopathy and chinese medicine, both of which are expensive treatments shown to work no better than a placebo. These could only be described as doing no harm (p.81) if there was definitely nothing wrong with the baby; and in that case, it would almost certainly be more effective to turn to one of Jackson’s other suggestions instead.

The section on feeding is clear and factual, but again emphasises the important of comfort over and above food, as illustrated by the study of tube-fed babies (p.21) showing that a full stomach does not always stop the crying.

Deborah Jackson has addressed co-sleeping in her book Three In A Bed. This is condensed into a single chapter in When Your Baby Cries, including safety information, along with many other gentle ways to help your baby sleep.

Other ‘rules’ include carrying baby in a sling, establishing a support network, and not bothering too much about the housework, all of which I fully agree with.

This book is firmly based at the attachment end of the parenting spectrum, but without any smug or judgmental tone. It allows space for parents to find their own style, and to cuddle their babies as much as they want to.


To Order When Your Baby Cries with a 25% discount, just follow the link and use the discount code KH25 at the checkout.