Kathy's Commentaries

References in Support of Katherine Dettwyler's Work

by Katherine A. Dettwyler, Ph.D.

Department of Anthropology,
Texas A & M University

2004 Update: These references are very old. I do not have the time to update them right now, but the Internet has evolved so much since 1996 that most anyone should be able to find the most recent research on any of these topics using http://www.google.com or PubMed.

Several people have asked for the scientific references supporting the claims made in some of the writings available on this web page. Here I provide just a small sample, on a variety of topics, below. I would like to make several additional points. If you look at this list and wonder why your own ob/gyn or pediatrician never mentioned this research to you, it is probably because (1) medical schools do not, for the most part, teach nutrition at all, let alone teach about breastfeeding, nor do they focus on preventing illness, (2) many doctors do not read the medical journals so they are not aware of recent research results, and (3) the infant formula industry is as huge and powerful as the tobacco industry.

There is no question that the use of infant formula raises the risk of getting a wide variety of diseases, both in infancy (ear infections, gastrointestinal infections, upper respiratory infections) and in later life (multiple sclerosis, cancer, diabetes), and that breastfed babies are at lower risk for all of these diseases by comparison. An important point to remember about relative risk, and reduction of risk, is that some diseases and conditions are very rare. Thus, one might ask "Is it worth changing one's behavior--breastfeeding instead of bottle-feeding--to reduce the risk of a rare event?" What is abundantly clear from the research comparing the health of breastfed and bottle-fed children is that the reduction in risk for any one disease may be small, and some of the diseases, such as childhood lymphomas, are very rare to begin with, but that the accumulated reduction in risk across all the diseases studied to date is substantial. A number of researchers think that the lower risk of many diseases in breastfed infants is due to their stronger immune systems, rather than specific mechanisms of protection for each condition. Thus, lower rates of lymphoma and multiple sclerosis in breastfed infants can probably be attributed to successful defense of the body by a strong immune system. In choosing whether, and for how long, to breastfeed, parents are making decisions that will have long-lasting consequences for their children's health. They need to be fully informed about the risks that may be avoided by breastfeeding, to make informed and responsible decisions. Just as parents today are informed about the risks involved in not using child safety seats, and drinking during pregnancy--dangers unknown a generation ago--parents today need access to information about the risks of infant formula and shortened durations of breastfeeding. No one would suggest that a parent whose child died in a car accident in the 1950s should "feel guilty" for not having used a child saftey seat before such seats were invented. Nor should parents feel guilty for having chosen to bottle-feed their children before knowledge of the health consequences has been made widely available.

As a final note, ALL of the studies that have looked at duration of breastfeeding have found that the longer the child nurses, the greater the benefit. There is never a point at which the child stops receiving health benefits from breast milk as long as his or her mother is lactating. The first month is obviously more critical than the 24th month or the 48th month, but the benefits continue to accrue. There are, of course, many other good reasons to breastfeed -- to have a happy child, to not have menstrual periods for many months, and it is very conveniently packaged and ready-to-go, not to mention cheap. I welcome private e-mail correspondence on these topics (e-mail address at the end), or interested parties can find up-to-date summaries of the literature on the relationship between breastfeeding and children's health my book, titled "Breastfeeding: Biocultural Perspectives," published by Aldine de Gruyter of New York.

YOU ASKED FOR REFERENCES, HERE ARE A FEW:

On IQ (and the lead analogy is based on "average IQ deficits" in children exposed to lead in situations like old apartment buildings where the paint had lead in it. I agree that IQ tests are suspect in general, but all of these studies have found small but significant benefits to the breastfed children. Whatever talent it is that IQ tests measure, breastfed babies are much better at it).

Bauer, G. et al. 1991 Breastfeeding and cognitive development of three-year-old children. Phychological Reports, 68:1218.

Lucas, A., et al. 1992 Breast milk and subsequent intelligence quotient in children born preterm. Lancet 339:261-264.

Morley, R. et al. 1988 Mother's choice to provide breast milk and developmental outcome. Archives of Disease in Childhood 63:1382-1385.

Morrow-Tlucak, M. et al. 1988 Breastfeeding and cognitive development in the first two years of life. Social Science and Medicine 26:635-639.

Rodgers, B. 1978 Feeding in infancy and later ability and attainments: A longitudinal study. Developmental Medicine and Child Neurology 20:421-426.

Rogan, W.J., and B.C. Gladen 1993 Breastfeeding and cognitive development. Early Human Development 31:181-193.

Taylor, B., and J. Wadsworth 1984 Breastfeeding and child development at five years of age. Developmental Medicine and Child Neurology 26:73-80.

Temboury, M.C. et al. 1994 Influence of breastfeeding on the infant's intellectual development. Journal of Pediatric Gastroenterology and Nutrition 18:32-36.

On allergies:

Jakobsson, I. and T. Lindberg 1978 Cow's milk as a cause of infantile colic in breast fed infants. Lancet 2:437-439.

In general:

Cunningham, A.S., D.B. Jelliffe and E.F.P. Jelliffe 1991 Breastfeeding and health in the 1980s: A global epidemiologic review. Journal of Pediatrics 118(5):659-666.

Greer, F.R. and R.D. Apple 1991 Physicians, formula companies, and advertising: A historical perspective. American Journal of Diseases of Children 145:282-286. (This article talks about the history of collusion between doctors and the infant formula industry. The formula industry gives hundreds of thousands of dollars to doctors and hospitals to promote their products, sponsors doctor's attendance at medical meetings, etc. The use of infant formula also causes more infant sickness, thus benefitting the doctors financially. No one gains financially when mothers breastfeed and children are healthy, except the parents who don't have to pay for formula or medical care).

Howie, P.W. et al. 1990 Protective effect of breast feeding against infection. British Medical Journal 300:11-16.

Jelliffe, D.B. and E.F.P. Jelliffe 1986 The uniqueness of human milk up-dated: Ranges of evidence and emphases in interpretation. Advances in International Maternal and Child Health 6:129-147.

Latham, M.C. 1975 Introduction. In "The Promotion of Bottle Feeding by Multinational Corporations: How Advertising and the Health Professions have Contributed," edited by T. Greiner. Ithaca, NY: Cornell International Nutrition Monograph Series, No. 2.

Rubin, D.H. et al. 1990 Relationship between infant feeding and infectious illness: A prospective study of infants during the first year of life. Pediatrics 85:464-471.

Walker, M. 1993 A fresh look at the risk of artificial infant feeding. Journal of Human Lactation 9(2):97-107.

On Sudden Infant Death Syndrome (SIDS):

Arnon, S.S. 1984 Breast feeding and toxigenic intestinal infections: Missing links in crib death. Reviews of Infectious Diseases 6:S193-S201.

Bernshaw, N.B. 1991 Does breastfeeding protect against sudden infant death syndrome? Journal of Human Lactation 7(2):73-79.

Fredrickson, D.D. et al. 1993 Relationship of sudden infant death syndrome to breast-feeding duration and intensity. American Journal of Diseases of Children 147:460. (They did a huge study, controlling for all other factors like ethnicity and maternal smoking, and found that for every month of exclusive breastfeeding, you cut the SIDS rate in half. Thus children breastfed for two months had 1/4 the rate of SIDS of bottle-fed babies, and those breastfed for three months had 1/8 the rate of SIDS, etc).

McKenna, J.J. et al. 1993 Infant-parent co-sleeping in evolutionary perspective: Imperatives for understanding infant sleep development and SIDS. Sleep 16(3):263-282.

On cancer:

Davis, M.K., D.A. Savitz, and B.I. Graubard 1988 Infant feeding and childhood cancer. Lancet 2(8607):365-368.

There are also two recent studies showing that breastfeeding protects daughters from getting breast cancer later in life, and that breastfeeding protects the mother from getting breast cancer. Between the two studies, they suggest that breastfeeding could cut a woman's breast cancer risk in half (if she had been breastfed as a child, and then breastfed her own children).

On necrotizing enterocolitis (NEC), which is a very nasty disease that many premature babies get and die from:

Lucas, A. and T.J. Cole 1990 Breast milk and neonatal necrotizing enterocolities. Lancet 336:1519-1523.

On ear infections:

Duncan, B. et al. 1993 Exclusive breast-feeding for at least 4 months protects against otitis media. Pediatrics 91(5):867-872.

On poorer response to immunizations in formula-fed children:

Hahn-Zoric, M. et al. 1990 Antibody responses to parenteral and oral vaccines are impaired by conventional and low protein formulas as compared to breast-feeding. Acta Paediatrica Scandinavica 79:1137-1142.

Pabst, H.F., and D.W. Spady 1990 Effect of breast-feeding on antibody response to conjugate vaccine. Lancet 336:269-270.

Prepared January 20, 1996.

Last updated March 16, 2004 , by kad. Contents copyright 1999-2004 by Sue Ann Kendall and Kathy Dettwyler. Thanks to Prairienet, the Free-Net of east-central Illinois , for hosting this site from 1999 through 2004.

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